Provider Demographics
NPI:1538237821
Name:ELLSASSER, JILL ANN (PAC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANN
Last Name:ELLSASSER
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:3100 CROSS CREEK PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2774
Mailing Address - Country:US
Mailing Address - Phone:248-377-8000
Mailing Address - Fax:248-377-2929
Practice Address - Street 1:3100 CROSS CREEK PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2774
Practice Address - Country:US
Practice Address - Phone:248-377-8000
Practice Address - Fax:248-377-2929
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2015-09-03
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Provider Licenses
StateLicense IDTaxonomies
MI5601002039363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical