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General NPI Number Information
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NPI Number | 1184317257
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Entity Type | Individual
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Provider Name | EILEEN FLEER APRN
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Gender | Female
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 5101 WASHINGTON ST STE 13
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City | GURNEE
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State | IL
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Zip | 60031-2988
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Country | US
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Telephone | 847-263-4343
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Fax |
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Provider Business Mailing Address
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Address Line | W6975 SAVANNAH LN
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City | DELAVAN
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State | WI
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Zip | 53115-4303
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Country | US
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Telephone | 815-693-5486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1403633
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209027792
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License Number State | IL
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