Ellis Clinical Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018206 Issued in IL

Legal business name

ELLIS CLINICAL SERVICES LLC

Practice address

2635 S Wabash Ave FL 3
Chicago, IL 60616

Phone

(773) 377-6141

NPI assigned

Oct 2, 2017

Organization subpart

No

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

Authorized official

Name

Nicola Ellis, LCSWNPI 1790129195

Title

Owner

Phone

(773) 793-7147

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicola Ellis, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1790129195
  Authorized official Same address or phone

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526169600000",
    "number": "1114437399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604020361",
            "telephone_number": "773-377-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 S WABASH AVE FL 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "773-377-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS CLINICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-05-13",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-793-7147",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018206",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorrie Elliott, M.D.
• Mary C Elliott
• Monae' D Elliott, PT, DPT
• Sterling Seth Elliott, PHARMD, BCMTMS
• William Elliott, M.D.
• Nikita Denae Ellis-Bibbs, RN
• Allison Ellis, MD, PHD
• Ashley Ellis, D.N.
• Christina Ann Ellis, LCSW
• Cody Ellis, MD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.