Provider Demographics
NPI:1467446930
Name:ACEVEDO, FRANCISCO JR (APRN, CNP)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:ACEVEDO
Suffix:JR
Gender:M
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21202 OWENS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-2038
Mailing Address - Country:US
Mailing Address - Phone:779-334-0030
Mailing Address - Fax:779-334-0031
Practice Address - Street 1:21202 OWENS RD STE 101
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-2038
Practice Address - Country:US
Practice Address - Phone:779-334-0030
Practice Address - Fax:779-334-0031
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001336A363L00000X, 363LF0000X
IL209-004145363LF0000X
IL277001115363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200183680Medicaid
1467446930OtherBLUECROSS/BLUESHIELD OF INDIANA
IN499810BMedicare PIN
INQ22218Medicare UPIN
IN200183680Medicaid