Schwartz, Ellissa A

Schwartz, Ellissa A is an individual health care provider with primary practice located at 6830 Villagreen Vw , Rockford IL 61107-5639. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Schwartz, Ellissa A can be contacted via phone (815) 282-1339.

Contact Information

Primary practice address
6830 Villagreen Vw Rockford IL 61107-5639
Phone: (815) 282-1339
Fax: (815) 282-1298
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-002771 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA #052890 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2370-023 Wisconsin

Profile Details

NPI number 1003029224
LBN Legal business name Schwartz, Ellissa A
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Nov 24th, 2009 - about 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1003029224 NPPES
Illinois Other 553180 MEDICARE GROUP PTAN
Illinois Other 834340 MEDICARE GROUP PTAN
Illinois Other 846930 MEDICARE GROUP PTAN

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