Provider Demographics
NPI:1891140554
Name:HARWARD, ELEANOR (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:
Last Name:HARWARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ELEANOR
Other - Middle Name:
Other - Last Name:NICKLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2650 WARRENVILLE RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 MADISON ST
Practice Address - Street 2:SUITE 280
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6549
Practice Address - Country:US
Practice Address - Phone:630-324-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical