Individual
MRS. TANYA NADINE EIKSTADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS. ED, ATC
Contact information
Practice address
5510 E STATE ST, ROCKFORD, IL 61108-2381
(815) 395-4505
(815) 395-4507
Mailing address
1827 N CHURCH ST, ROCKFORD, IL 61103-4620
(815) 871-4859
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
08/21/2006
Last updated
07/21/2022
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