Ellis, Lisa A

Ellis, Lisa A is an sole proprietor health care provider with primary practice located at 309 S Fair St , Champaign IL 61821-3122. She recently has only one registered license in Agencies / Early Intervention Provider Agency, which is considered as her primary health care specialty. Ellis, Lisa A can be contacted via phone (217) 377-9348.

Contact Information

Primary practice address
309 S Fair St Champaign IL 61821-3122
Phone: (217) 377-9348
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1487892485
LBN Legal business name Ellis, Lisa A
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 28th, 2009
Last updated Apr 24th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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