Search › Illinois › 171M00000X
De'Juan Ellsworth
NPI 1467821587 · on the registry since 2015
Practice
- Address
- 2310 W Roosevelt Rd
Chicago, IL 60608 - Phone
- (312) 566-4500
- Organisation at this address
- Catholic Charities Of The Archdiocese Of Chicago
The Board Of Trustees Of The University Of IllinoisInferred from a shared address, not stated in the registry. - Clinicians at this address
- 51
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Also registered as
- 101Y00000X
101Y00000X - Licence states on file
- LA, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-05-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois