Individual provider Active NPI

Michael Cecchetto, FNP-BC

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1437706314
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209019851 Issued in IL
Practice address
2868 N Broadway St
Chicago, IL 60657-6017
Phone
(569) 352-5773
NPI assigned
Aug 24, 2019
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209019851 IL Primary

Addresses

Primary practice location

2868 N Broadway St
Chicago, IL 60657-6017

Mailing address

779 W Adams St
Chicago, IL 60661-3509
Phone (312) 752-4466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730000373 IL Practitioner - Nurse Practitioner 1153746789 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

825 S State St
Chicago, IL 60605-2225
Phone (312) 566-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Sep 25, 2023 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jul 1, 2020 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

2868 N Broadway St
Chicago, IL 60657
Phone (773) 569-3525

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

779 W Adams St
Chicago, IL 60661
Phone (312) 382-8308

800 W Fulton Market
Fl 12
Chicago, IL 60607

825 S State St
Chicago, IL 60605
Phone (312) 566-9510

515 Belt Line Rd
Collinsville, IL 62234
Phone (618) 344-7882

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

7425 Barrington Rd
Hanover Park, IL 60133
Phone (630) 823-0392

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1437706314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 W ADAMS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613509",
            "telephone_number": "312-752-4466",
            "fax_number": "312-559-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2868 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576017",
            "telephone_number": "569-352-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECCHETTO",
        "first_name": "MICHAEL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-24",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.