Healthcare Provider Details

I. General information

NPI: 1831980028
Provider Name (Legal Business Name): NANCY A EWART MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY A HODGE MA

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 W OTTAWA RD
PAXTON IL
60957-4090
US

IV. Provider business mailing address

PO BOX 162
PAXTON IL
60957-0162
US

V. Phone/Fax

Practice location:
  • Phone: 217-379-4302
  • Fax: 217-817-0379
Mailing address:
  • Phone: 217-379-4302
  • Fax: 217-817-0379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178022995
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: