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Individual

CAROLE J EATOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1511 N BLACKHAWK BLVD, ROCKTON, IL 61072-1513
(815) 395-5879
(815) 624-2186
Mailing address
1511 N BLACKHAWK BLVD, ROCKTON, IL 61072-1513
(815) 395-5879
(815) 624-2186

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209008398
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209008398
ADVANCED PRACTICE NURSE
IL
Enumeration date
10/21/2010
Last updated
10/21/2010
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