Provider Demographics
NPI:1336378348
Name:ACREE, MARY ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELLEN
Last Name:ACREE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 CENTRAL ST STE 800
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1780
Mailing Address - Country:US
Mailing Address - Phone:847-657-5959
Mailing Address - Fax:847-657-5764
Practice Address - Street 1:1000 CENTRAL ST STE 800
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1780
Practice Address - Country:US
Practice Address - Phone:847-657-5959
Practice Address - Fax:847-657-5764
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.132125207R00000X, 208000000X
IL0361321252080P0208X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases