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Contact Information

EDWARD C ELLIOTT III
2 MEMORIAL DR STE 305
DECATUR, IL62526-3999
 Phone: 217-876-4830
 Fax: 217-876-8385
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for EDWARD C ELLIOTT III · (Male)

NPI Number 1083957088
Status Active
Credentials
Entity Individual
Enumeration date 03/28/2013
Last updated 03/11/2026 - About 3 months ago
Sole proprietor 1 No
Identifiers
  • IL License # 016-005738
  • OR License # DP220790
Hospital affiliation(s)
  • DECATUR MEMORIAL HOSPITAL - (Acute Care)
    2300 NORTH EDWARD STREET
    DECATUR, IL 62526
  • ST MARYS HOSPITAL - (Acute Care)
    1800 E LAKE SHORE DR
    DECATUR, IL 62521
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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