Provider Demographics
NPI:1699277038
Name:SOLIS, EILEEN A (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:A
Last Name:SOLIS
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 DORAL DR
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IL
Mailing Address - Zip Code:60152-3385
Mailing Address - Country:US
Mailing Address - Phone:815-568-6069
Mailing Address - Fax:
Practice Address - Street 1:1004 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-3955
Practice Address - Country:US
Practice Address - Phone:847-482-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041314614207QA0505X
IL209.017137363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine