Healthcare Provider Details

I. General information

NPI: 1699277038
Provider Name (Legal Business Name): EILEEN A SOLIS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 LOGAN AVE
BELVIDERE IL
61008-3955
US

IV. Provider business mailing address

705 DORAL DR
MARENGO IL
60152-3385
US

V. Phone/Fax

Practice location:
  • Phone: 847-482-6365
  • Fax:
Mailing address:
  • Phone: 815-568-6069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number041314614
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number209.017137
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: