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General NPI Number Information
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NPI Number | 1063439503
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Entity Type | Individual
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Provider Name | JAMES ELLIS D.O., FACEP
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 503 N MAPLE ST
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City | EFFINGHAM
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State | IL
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Zip | 62401-2006
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Country | US
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Telephone | 217-337-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 75 REMIT DRIVE LOCKBOX 6065
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City | CHICAGO
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State | IL
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Zip | 60675-6065
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Country | US
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Telephone | 866-916-5259
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Fax | 231-922-4030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-099455
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | H46397
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | H6194
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO20976
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License Number State | DC
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO25267
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License Number State | DC
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101018060
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4011
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License Number State | IA
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Taxonomy #8
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0533706
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License Number State | KS
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Taxonomy #9
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.009604
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License Number State | OH
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