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BENJAMIN DAVID ELLISON DO
NPI 1043007123
Student in an Organized Health Care Education/Training Program in Olympia Fields, IL

Active since April 22, 2025PECOS Enrolled
20201 CRAWFORD AVE STE 1276, OLYMPIA FIELDS, IL 60461(708) 679-2270 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Benjamin David Ellison Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN DAVID ELLISON DO (NPI 1043007123) is an individual student in an organized health care education/training program in Olympia Fields, Illinois and active in the NPI registry since April 2025. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043007123
Entity TypeIndividual
Primary Taxonomy390200000X
Provider Legal NameBENJAMIN DAVID ELLISONCredential: DO
Location Address20201 CRAWFORD AVE STE 1276Olympia Fields, IL 60461-1010
Mailing Address20201 Crawford Ave Ste 1276Olympia Fields, IL 60461-1010
Phone(708) 679-2270
Sole ProprietorNo
Enumeration DateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1043007123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
20201 CRAWFORD AVE STE 1276, Olympia Fields, IL 60461
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Benjamin David Ellison Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FLORIAN A STROIE DO
Urology
20201 CRAWFORD AVE STE 1276
OLYMPIA FIELDS, IL 60461
Cook County (708) 855-7684

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Ellison's NPI number?

The NPI number for Benjamin Ellison is 1043007123. It was assigned to this individual provider in the NPPES registry on April 22, 2025.

Where is Benjamin Ellison located?

Benjamin Ellison practices at 20201 Crawford Ave Ste 1276, Olympia Fields, IL 60461. The listed phone number is (708) 679-2270.

What is Benjamin Ellison's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Benjamin Ellison enrolled in Medicare?

Yes. Benjamin Ellison is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Benjamin Ellison was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.