Minimol Ravu Arackal, RN,MSN,FNP-BC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.335478 Issued in IL

Practice address

505 Dover Dr
Des Plaines, IL 60018-5545

Phone

(847) 813-9119

NPI assigned

Dec 5, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Minimol Antony Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1023353877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 DOVER DR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600185545",
            "telephone_number": "847-813-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 DOVER DR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600185545",
            "telephone_number": "847-813-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARACKAL",
        "first_name": "MINIMOL",
        "middle_name": "RAVU",
        "name_prefix": "Mrs.",
        "credential": "RN,MSN,FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.335478",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINIMOL",
            "last_name": "ANTONY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.