Martin Ira Ellenby M.D.

NPI 1184624819 - Surgery - 208600000X

NPI Details
NPI 1184624819
Gender Male
Enumeration Date 07/22/2005
Last Updated 06/09/2014
Entity Type Individual
Active Over 12 years ago
Practice Location
4400 W 95TH ST
SUITE 205
OAK LAWN IL, 60453-2654, US
Phone (708) 346-4040
Fax (708) 346-3287
Business Location
4400 W 95TH ST
SUITE 205
OAK LAWN IL, 60453-2654, US
Phone (708) 346-4040
Fax (708) 346-3287
Toxanomy
Taxonomy Code 208600000X
License State Illinois
License Number 036077308
Remove 1184624819 NPI Number
 

According to our database, Dr. Martin Ira Ellenby M.D. NPI is 1184624819, taxonomy code is 208600000X and license number is 036077308, license state is located at Illinois. Martin Ira Ellenby M.D. physically located at 4400 W 95th St, Oak Lawn IL, 60453-2654. NPI Number Martin Ira Ellenby M.D. has the Individual type.

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1184624819 NPI number is provided on an as is basis without warranty of any kind. 1184624819 is maintained by the National Plan & Provider Enumeration System. The contents of Martin Ira Ellenby M.D. are for informational purposes only.