Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrew Benjamin Eytalis

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1609581453

Andrew Benjamin Eytalis is a Student in an Organized Health Care Education/Training Program in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2023.

Licensed in
IL
In the registry since
2023
Specialties on file
2

Practice location Address checks out

695 N Perryville Rd Ste 4
Rockford, IL 61107-6225
Phone: (779) 368-0060
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 178021163 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1609581453
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 17, 2023
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025
Mailing address695 N Perryville Rd, Rockford, IL 61107-6225

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