Basic Information
| Provider Information | |||||||||
| NPI: | 1023289410 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROY | ||||||||
| FirstName: | ELLEN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3060 W SALT CREEK LN | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600051069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476183487 | ||||||||
| FaxNumber: | 8476183489 | ||||||||
| Practice Location | |||||||||
| Address1: | 880 W CENTRAL RD | ||||||||
| Address2: | SUITE 5000 | ||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600052355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476183800 | ||||||||
| FaxNumber: | 8476183809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2008 | ||||||||
| LastUpdateDate: | 12/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.