Healthcare Provider Details

I. General information

NPI: 1861044588
Provider Name (Legal Business Name): JOCELYN S ARACKAL FNP,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 ROOSEVELT RD STE 100
GLEN ELLYN IL
60137-6141
US

IV. Provider business mailing address

885 ROOSEVELT RD STE 100
GLEN ELLYN IL
60137-6141
US

V. Phone/Fax

Practice location:
  • Phone: 630-938-6000
  • Fax: 630-384-6229
Mailing address:
  • Phone: 630-938-6000
  • Fax: 630-384-6229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277001769
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209019502
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.019502
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.001769
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.390946
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: