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Next Update: Thursday, December 19, 2024 2:50 AM CST
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ELLIS, CAREY EUGENE
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
400 S. KENNEDY DRIVE STE. 100
BRADLEY IL 60915
Address last updated on 11/13/2003 |
| Phone #: |
(815) 928-8050 x197 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
22993 |
| Dated: |
6/28/2002 |
| Expires: |
6/1/2008 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine
Sports Medicine (Family Practice) |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Keck Sch of Med of the USC, LOS ANGELES CA 90089 |
| Graduated: |
6 /
1994 |
| CME Year: |
2008 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF FAMILY MEDICINE |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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| Locations: |
Hours: |
Languages: |
400 S. KENNEDY DRIVE STE. 100
BRADLEY IL 60915
Phone #:
(815) 928-8050 x197
Fax #:
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Mon: 8:30AM - 5:00PM OFF
Tue: 8:30AM - 5:00PM
Wed: 8:30AM - 5:00PM CLOSED
Thu: 8:30AM - 5:00PM
Fri: 8:30AM - 5:00PM
Sat: 8:30AM - 5:00PM
Sun: 8:30AM - 5:00PM |
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