Erynn Elizabeth Elleby, M.D.
Individual provider Active NPI Family Medicine Physician · Shiloh, IL
NPI 1881033710 · NPPES record last updated Dec 29, 2021
Key facts
- NPI
- 1881033710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036140501 (IL)
- Practice address
- 1116 Hartman LN
Shiloh, IL 62221-8014 - Phone
- (618) 641-9011
- NPI assigned
- Jun 25, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- HSHS Medical Group Inc
Practice addresses (Care Compare)
1116 Hartman LN
Shiloh, IL 62221-8014
Phone (618) 641-9011
Hospital & facility affiliations
- HSHS Home Care Illinois
- Apollo Medical
- HSHS St Elizabeth'S Hospital
- St Johns Hospital
- Memorial Hospital
- St Josephs Hospital
- Barnes Jewish Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.81 of 100
- Quality
- 85.98
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160621000402 | IL | Practitioner - Family Practice | 2961704481 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036140501 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Current |
Accepting new patients | |
| HSHS Medical Group Inc | Current |
Accepting new patients | |
| HSHS Medical Group Inc | Past | Accepting new patients |
Locations
1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889
1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100
1116 Hartman Ln
Shiloh, IL 62221
Phone (618) 641-5803
3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036140501 | IL | Yes |
Addresses
Primary practice location
1116 Hartman LN
Shiloh, IL 62221-8014
Mailing address
1116 Hartman LN
Shiloh, IL 62221-8014
Phone (618) 641-9011
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eelleby104323@ewd.direct.hshs.org | Direct |
Other providers in Shiloh, IL
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- Bertram E Drury
- Julia Dungan
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- Kristi Lyn Emmons
- Empowerme Rehabilitation Il Agency, LLC
- Empowerme Rehabilitation Illinois, LLC
- English and McLaughlin, P.C.
- Lindsey Nicole Erickson
All providers in Shiloh, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.