Healthcare Provider Details

I. General information

NPI: 1447707880
Provider Name (Legal Business Name): ISABEL BETANCOURT FNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15234 S HARLEM AVE
ORLAND PARK IL
60462-4330
US

IV. Provider business mailing address

15234 S HARLEM AVE
ORLAND PARK IL
60462-4330
US

V. Phone/Fax

Practice location:
  • Phone: 708-888-8287
  • Fax:
Mailing address:
  • Phone: 708-888-8287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209015051
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041310113
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: