Eleanor Lynn Vanderklok, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP010656 Issued in PA

Practice address

925 Chestnut St
Suite 320a
Philadelphia, PA 19107-4216

Phone

(215) 955-8874

NPI assigned

Aug 10, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1013222413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "SUITE 320A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "SUITE 320A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKLOK",
        "first_name": "ELEANOR",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102894693",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eli Joseph Vandenberg, LSW
• Vander LLC
• Brian L Vanderbeek, MD
• Paul Vanderbeek, MD
• Leah Vanderhorst
• Mark William Vanderland, MD
• David Vanderlyke, DPM
• Amy Sorrento Vanderveer, MA, BC-DMT, LPC
• Adeline Vanderver, MD
• Paul G. Vandervoort, CRNA

• Adult Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.