Provider Demographics
NPI:1316716772
Name:EUBANK, DANETTE MCCRAY
Entity type:Individual
Prefix:
First Name:DANETTE
Middle Name:MCCRAY
Last Name:EUBANK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21306 STATE ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:IL
Mailing Address - Zip Code:61568-9252
Mailing Address - Country:US
Mailing Address - Phone:309-267-7713
Mailing Address - Fax:
Practice Address - Street 1:21306 STATE ROUTE 9
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:IL
Practice Address - Zip Code:61568-9252
Practice Address - Country:US
Practice Address - Phone:309-267-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No171400000XOther Service ProvidersHealth & Wellness Coach