Active NPI
Daniel Ellis
- Professional Counselor
- Watseka, IL
National Provider Identifier
1740538065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 323 W Mulberry St
Watseka, IL 60970-1568 - Phone
- (815) 432-5241
- Fax
- (815) 432-4537
- NPI assigned
- Aug 16, 2012
- Last updated
- Aug 16, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NU | Primary |
Addresses
Primary practice location
323 W Mulberry St
Watseka, IL 60970-1568
Mailing address
323 W Mulberry St
PO Box 322
Watseka, IL 60970-1568
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1740538065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 W MULBERRY ST",
"address_2": "PO BOX 322",
"city": "WATSEKA",
"state": "IL",
"postal_code": "609701568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 W MULBERRY ST",
"city": "WATSEKA",
"state": "IL",
"postal_code": "609701568",
"telephone_number": "815-432-5241",
"fax_number": "815-432-4537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-16",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watseka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.