Provider Demographics
NPI:1326683665
Name:FOLLETT, ELLEN MARIA (NP)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:MARIA
Last Name:FOLLETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:2350 ROYAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4718
Mailing Address - Country:US
Mailing Address - Phone:847-695-8100
Mailing Address - Fax:847-695-6808
Practice Address - Street 1:2350 ROYAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4718
Practice Address - Country:US
Practice Address - Phone:847-695-8100
Practice Address - Fax:847-695-6808
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209020163363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner