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Individual

KELLY NICHOLE ECKHART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
600 W GRAND AVE, LAKE VILLA, IL 60046-8034
(847) 245-6262
(847) 356-0364
Mailing address
23870 W TOWNLINE RD, GRAYSLAKE, IL 60030-9764
(847) 609-5760

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.413014
IL
163W00000X
Registered Nurse
Primary
197954-30
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.034966
IL

Other

Enumeration date
07/19/2016
Last updated
03/30/2026
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