Healthcare Provider Details

I. General information

NPI: 1437095171
Provider Name (Legal Business Name): MERCEDEZ VANDECASTEELE DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 W ADAMS ST
CHICAGO IL
60661-3509
US

IV. Provider business mailing address

1330 W MADISON ST APT 3F
CHICAGO IL
60607-1975
US

V. Phone/Fax

Practice location:
  • Phone: 312-382-8308
  • Fax:
Mailing address:
  • Phone: 309-236-6936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.036388
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number041486985
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: