Provider Demographics
NPI:1902265820
Name:VAKHER, ELEONOR
Entity Type:Individual
Prefix:
First Name:ELEONOR
Middle Name:
Last Name:VAKHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 CARIBOU LN
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9359
Mailing Address - Country:US
Mailing Address - Phone:847-707-2992
Mailing Address - Fax:
Practice Address - Street 1:2450 CARIBOU LN
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-9359
Practice Address - Country:US
Practice Address - Phone:847-707-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-20
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5048-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant