MEDICARE: FRANCISCO ACEVEDO JR. APRN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71001336A	IN
2	363LF0000X	Family Nurse Practitioner	209-004145	IL
3	363LF0000X	Family Nurse Practitioner	71001336A	IN
4	363L00000X	Nurse Practitioner	277001115	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1467446930	OTHER		BLUECROSS/BLUESHIELD OF INDIANA

General Provider Information

NPI Number	:	1467446930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCISCO ACEVEDO JR. APRN, CNP

Provider Business Mailing Address
First Line	:	21202 OWENS RD STE 101
Second Line	:
City	:	MOKENA
State	:	IL
Zip	:	60448-2038
Country	:	US
Telephone Number	:	779-334-0030
Fax Number	:	779-334-0031

Provider Business Practice Location Address
First Line	:	21202 OWENS RD STE 101
Second Line	:
City	:	MOKENA
State	:	IL
Zip	:	60448-2038
Country	:	US
Telephone Number	:	779-334-0030
Fax Number	:	779-334-0031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	05/22/2024

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