Diane Marie Ellig, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.012905 Issued in IL

Practice address

430 Warrenville Rd Ste 310
Lisle, IL 60532-1348

Phone

(630) 789-4910

Fax

(630) 432-6744

NPI assigned

Sep 29, 2015

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

Other names 1

• Diane M Mackey Former name

Electronic endpoints 2

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 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.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1700256153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WARRENVILLE RD STE 310",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321348",
            "telephone_number": "630-789-4910",
            "fax_number": "630-432-6744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "908 N Elm St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213635",
            "country_code": "US",
            "telephone_number": "630-789-4910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIG",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dellig230581@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd Ste 310",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dellig230581@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "908 N Elm St Suite 103, Hinsdale IL 60521",
            "address_1": "908 N Elm St Ste 103",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "MACKEY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edward Health Ventures
• Edward Health Ventures
• Nancy Eiseman, M.D.
• Aniema Ekong
• Elevated Mind Counseling, LLC
• Tarah Ellington, MED, ATC, CSCS,
• Empower Performance LLC
• Empowering Expressions LLC
• Julie M Ensinger, O.D.
• Epic Surgical Solution Company

• Family Nurse Practitioner in Lisle, IL
• Providers in Lisle, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.