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NPI Code Detail

MEDICARE: TRACY EAKLE APRN

MEDICARE: TRACY EAKLE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner209026644IL
2363LG0600XGerontology Nurse Practitioner209026644IL

General Provider Information

NPI Number : 1578276051
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY EAKLE APRN
Provider Business Mailing Address
First Line : 2006 AVENUE D
Second Line :
City : STERLING
State : IL
Zip : 61081-1188
Country : US
Telephone Number : 815-988-0635
Fax Number :
Provider Business Practice Location Address
First Line : 5666 E STATE ST
Second Line :
City : ROCKFORD
State : IL
Zip : 61108-2425
Country : US
Telephone Number : 815-226-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2022
Last Update Date : 06/29/2026

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Directions to “ TRACY EAKLE APRN” Practice Location

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