MEDICARE: MS. CECILIA ACKMANN APN, 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	163W00000X	Registered Nurse		IL
2	363LF0000X	Family Nurse Practitioner		IL

General Provider Information

NPI Number	:	1649284357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CECILIA ACKMANN APN, CNP

Provider Business Mailing Address
First Line	:	1520 BRUMMEL ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-3708
Country	:	US
Telephone Number	:	847-733-1520
Fax Number	:	773-404-2484

Provider Business Practice Location Address
First Line	:	4015 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2593
Country	:	US
Telephone Number	:	773-404-0447
Fax Number	:

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/11/2025

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