Provider Demographics
NPI:1578385894
Name:EAGER, MADELINE LEE (DC)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:LEE
Last Name:EAGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 E 529 RD
Mailing Address - Street 2:
Mailing Address - City:MENDOTA
Mailing Address - State:IL
Mailing Address - Zip Code:61342
Mailing Address - Country:US
Mailing Address - Phone:815-503-0205
Mailing Address - Fax:
Practice Address - Street 1:105 OTTAWA ST
Practice Address - Street 2:
Practice Address - City:TROY GROVE
Practice Address - State:IL
Practice Address - Zip Code:61372
Practice Address - Country:US
Practice Address - Phone:815-503-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038014193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor