Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Stephanie M Ellis, PA

Individual provider Physician Assistant · NPI 1922313238

Mrs. Stephanie M Ellis, PA is a Physician Assistant in Peoria, Illinois. Graduated from Midwestern University, Chicago College of Osteopathic Med in 2010, 16 years ago. Practices with Jason B. Amato, MD Dermatology, LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
16
Trained at
Midwestern University, Chicago College of Osteopathic Med
Licensed in
IL
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4909 N Glen Park Place Rd
Peoria, IL 61614-4676
Phone: (309) 674-7546
Fax: (309) 282-0500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (IL)

Record details

NPI number1922313238
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 11, 2010
Last updated in NPPESAugust 11, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated 2010 (16 years in practice)
Group practice Jason B. Amato, Md Dermatology, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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