Active NPI
Ellen Wu
- Dermatology Physician
- Chicago, IL
National Provider Identifier
1104309459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 344756
- Practice address
- 240 E Huron St Ste 1-200
Chicago, IL 60611-2909 - Phone
- (312) 503-7975
- NPI assigned
- Sep 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 344756 | NY | Primary |
Addresses
Primary practice location
240 E Huron St Ste 1-200
Chicago, IL 60611-2909
Mailing address
240 E Huron St Ste 1-200
Chicago, IL 60611-2909
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230607002486 | IL | Order and Referring Only - Dermatology | 7517324452 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- ellen.wu.1@3547.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785110400000",
"number": "1104309459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 E HURON ST STE 1-200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 E HURON ST STE 1-200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112909",
"telephone_number": "312-503-7975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WU",
"first_name": "ELLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-12",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "344756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.