Healthcare Provider Details

I. General information

NPI: 1992600233
Provider Name (Legal Business Name): ELEANOR KATHLEEN EAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 4TH ST
PERU IL
61354-3507
US

IV. Provider business mailing address

1627 4TH ST
PERU IL
61354-3507
US

V. Phone/Fax

Practice location:
  • Phone: 815-223-4479
  • Fax: 815-223-4489
Mailing address:
  • Phone: 815-223-4479
  • Fax: 815-223-4489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160.010624
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: