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Contact Information

ELLISSA A SCHWARTZ, PHYSICIAN ASSISTANT
6830 VILLAGREEN VW
ROCKFORD, IL61107-5639
 Phone: 815-282-1339
 Fax: 815-282-1298
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ELLISSA A SCHWARTZ · (Female)

NPI Number 1003029224
Status Active
Credentials PHYSICIAN ASSISTANT
Entity Individual
Enumeration date 05/07/2007
Last updated 11/24/2009 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085-002771
  • PA License # MA #052890
  • WI License # 2370-023
  • IL Other 553180 MEDICARE GROUP PTAN
  • IL Other 834340 MEDICARE GROUP PTAN
  • IL Other 846930 MEDICARE GROUP PTAN
Hospital affiliation(s)
  • SAINT ANTHONY MEDICAL CENTER - (Acute Care)
    5666 EAST STATE STREET
    ROCKFORD, IL 61108
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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