Eaton, Kathy Lynn

Eaton, Kathy Lynn is an individual health care provider with primary practice located at 2106 W Springfield Ave , Champaign IL 61821-2933. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Eaton, Kathy Lynn can be contacted via phone (217) 954-1347.

Contact Information

Primary practice address
2106 W Springfield Ave Champaign IL 61821-2933
Phone: (217) 954-1347
Fax: (217) 954-1361
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019025342 Illinois
Dental Providers / Dentist 122300000X 019.025342 Illinois

Profile Details

NPI number 1821100371
LBN Legal business name Eaton, Kathy Lynn
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 24th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821100371 NPPES
Illinois MEDICAID 9184608

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