Search › Illinois › 224Z00000X
Kimyetta Ellis
NPI 1538630181 · on the registry since 2018 · sole proprietor
Practice
- Address
- 18321 California Ave
Homewood, IL 60430 - Phone
- (708) 261-6506
Registry record
- Primary taxonomy
- 224Z00000X
224Z00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-12-07
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