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General NPI Number Information
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NPI Number | 1083499453
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Entity Type | Individual
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Provider Name | ELLYSSE BERTUS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 500 W MONROE ST STE 1300
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City | CHICAGO
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State | IL
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Zip | 60661-3704
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Country | US
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Telephone | 877-751-5783
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Fax |
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Provider Business Mailing Address
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Address Line | 500 W MONROE ST STE 1300
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City | CHICAGO
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State | IL
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Zip | 60661-3704
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP031914
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024192966
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704425584
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN100023833
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 29756
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11027770
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021470
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC007335
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License Number State | MD
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