Debora Ellis, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

277.000609 Issued in IL

Practice address

201 E Ogden Ave Ste 118
Hinsdale, IL 60521-3776

Phone

(630) 270-7717

Fax

(779) 803-3119

NPI assigned

Jan 12, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Connections Medical Group Associates LLCGroup PAC ID 2365662517, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connections Medical Group Associates LLC

  • Child & Adolescent Psychiatry Physician
  • New Lenox, IL
  • NPI 1548697618
  Medicare reassignment Care Compare group NPD
• Spectrum Private Client

  • Child & Adolescent Psychiatry Physician
  • Hinsdale, IL
  • NPI 1659086809
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1003352196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 CALISTOGA DR STE 2S",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604514833",
            "telephone_number": "815-418-6070",
            "fax_number": "708-923-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E OGDEN AVE STE 118",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213776",
            "telephone_number": "630-270-7717",
            "fax_number": "779-803-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DEBORA",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277.000609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ash A Eldifrawi, PSY.D.
• Elevate Counseling and Wellness LLC
• Luan Elezi, M.D.
• Sarah Michelle Elfman, LSW
• Daniel Andreas Elke, M.D
• John Richard Ellis, DDS
• Emergency Healthcare Physicians, LTD.
• Emily Pagone Counseling, PLLC
• Margaret Engel, LPC
• Muna Enshiwat-Salman, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.