Healthcare Provider Details

I. General information

NPI: 1144112921
Provider Name (Legal Business Name): LUDYVINA ACOSTA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 OGDEN AVE STE 260
AURORA IL
60504-5896
US

IV. Provider business mailing address

2000 OGDEN AVE STE P050
AURORA IL
60504-7222
US

V. Phone/Fax

Practice location:
  • Phone: 630-898-6409
  • Fax: 630-898-3646
Mailing address:
  • Phone: 630-499-2404
  • Fax: 630-499-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number209032870
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209032870
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: