Healthcare Provider Details

I. General information

NPI: 1447411483
Provider Name (Legal Business Name): EILEEN MAGILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 04/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N HIGHLAND AVE
AURORA IL
60506-3814
US

IV. Provider business mailing address

8321 W NORTH AVE
MELROSE PARK IL
60160-1605
US

V. Phone/Fax

Practice location:
  • Phone: 630-892-4355
  • Fax: 630-892-2832
Mailing address:
  • Phone: 708-681-2298
  • Fax: 708-681-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209007067
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: