Provider Demographics
NPI:1467329169
Name:EILDERS, WENDY S
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:S
Last Name:EILDERS
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 1:421 E BENTON AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:IL
Mailing Address - Zip Code:61085-1403
Mailing Address - Country:US
Mailing Address - Phone:815-520-0166
Mailing Address - Fax:
Practice Address - Street 1:300 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:APPLE RIVER
Practice Address - State:IL
Practice Address - Zip Code:61001-9455
Practice Address - Country:US
Practice Address - Phone:815-520-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist