Healthcare Provider Details

I. General information

NPI: 1598103483
Provider Name (Legal Business Name): ELIZABETH M EYLES D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4614 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-6722
US

IV. Provider business mailing address

4614 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-6722
US

V. Phone/Fax

Practice location:
  • Phone: 815-477-8844
  • Fax:
Mailing address:
  • Phone: 815-477-8844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.012421
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: