ALEXIS ELLSTROM PAC
NPI 1114560695
Physician Assistant in Forest Park, IL

Q: What is Alexis Ellstrom's NPI number?

The NPI number for Alexis Ellstrom is 1114560695. It was assigned to this individual provider in the NPPES registry on October 28, 2019.

Q: What is Alexis Ellstrom's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Alexis Ellstrom was last updated on October 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since October 28, 2019PECOS EnrolledAccepts Medicare Assignment

8200 ROOSEVELT RD, FOREST PARK, IL 60130(872) 231-3162 Get Directions Write a Review

NPPES record last updated: October 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 7, 2025, Oct 28, 2019 (2 updates tracked since 2019).

On this page

About Alexis Ellstrom Pac NPPES

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

ALEXIS ELLSTROM PAC (NPI 1114560695) is an individual physician assistant in Forest Park, Illinois, licensed in Illinois (085.007289) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS and is a graduate of Southern Illinois University School Of Medicine (2019).

NPPES Registry Identity

NPI1114560695

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameALEXIS ELLSTROMCredential: PAC

Location Address8200 ROOSEVELT RDForest Park, IL 60130-2528

Mailing AddressPo Box 74008272Chicago, IL 60674-8272 · (702) 899-0595 · Fax (702) 977-1496

Phone(872) 231-3162

Sole ProprietorYes

Medical School CMSSouthern Illinois University School Of MedicineGraduated 2019

Enumeration DateOctober 28, 2019

Last NPPES UpdateOctober 7, 20252 updates tracked since enumeration

NPPES CertifiedOctober 7, 2025

✔ NPI 1114560695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085.007289

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

8200 ROOSEVELT RD, Forest Park, IL 60130

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alexis Ellstrom Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830522259

PECOS Enrollment IDI20191125002433

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

3,692 services354 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

360 services234 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

130 services130 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60130 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

MELANIE KETCHMARK

Physical Therapist