Terence B Ellis

Primary specialty

Cardiovascular Specialist/TechnologistTaxonomy code 246X00000X

Practice address

10537 S Ewing Ave
Lower Level
Chicago, IL 60617-6220

Phone

(312) 212-4570

Fax

(773) 734-0407

NPI assigned

Sep 12, 2007

Last updated

Sep 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Heart Care USA

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1306031331
  NPD (past) Authorized official

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1679768675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10537 S EWING AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176220",
            "telephone_number": "312-212-4570",
            "fax_number": "773-734-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10537 S EWING AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176220",
            "telephone_number": "312-212-4570",
            "fax_number": "773-734-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TERENCE",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246X00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicola Ellis, LCSW
• Nicole Ellis, LPC
• Rebecca Ellis, LPC
• Sue Ellis
• Tarryn Ellis, NP
• Tierra Ellis
• Gabrielle Renee Ellison, LCPC
• Jana S. Ellison, MS, OTR/L
• Kelly Ann Ellison
• Latisha Ellison

• Cardiovascular Specialist/Technologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Cardiovascular Specialist/Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.