Andrew Benjamin Eytalis
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 4Rockford, IL 61107-6225
Phone: (779) 368-0060
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Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X · Licence 178021163 (IL) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1609581453 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 17, 2023 |
| Last updated in NPPES | July 31, 2025 |
| Certification date | July 31, 2025 |
| Mailing address | 695 N Perryville Rd, Rockford, IL 61107-6225 |
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