DE
DONALD ELLIS
ED580878 · 03/22/1957 · Updated 04/10/2026
Active
Basic Information
| Patient Record Number: | ED580878 |
| Date of Birth: | 03/22/1957 |
| Age: | 69 |
| Sex: | male |
| SSN: | N/A |
| Medicare Number: | N/A |
| Last Updated: | 04/10/2026 05:29 PM |
Contact Information
| Mobile Phone: | (773) 536-6936 |
| Home Phone: | N/A |
| Email: | N/A |
| Emergency Contact: | N/A |
| Emergency Phone: | N/A |
| Last Seen: | Never |
| Provider: | Kalpana Mutyala |
Address Information
4655 W Berteau Ave
106
Chicago, IL 60641 Coordinates: 41.9562284, -87.7448841
106
Chicago, IL 60641 Coordinates: 41.9562284, -87.7448841
Home Health Nurse
EXCELL HOME HEALTH PLUS
| Phone: | 708-400-8971 |
| Fax: | 708-867-0400 |
| Status: | Active |
Medicare Part B Deductible
No deductible information available
Annual Wellness Visit
No wellness visit information available
Discharge History
View AllNo discharge history
Patient Actions
Appointment History
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Patient Documents
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Total Claims-
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Payment RateRemittance Claims
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