Active NPI
Kylie Marissa Arceo, NP
- Family Nurse Practitioner
- Joliet, IL
National Provider Identifier
1710754619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.028991
- Practice address
- 2450 Glenwood Ave
Joliet, IL 60435-5463 - Phone
- (815) 370-8822
- NPI assigned
- Dec 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.028991 | IL | Primary |
Addresses
Primary practice location
2450 Glenwood Ave
Joliet, IL 60435-5463
Mailing address
2450 Glenwood Ave
Joliet, IL 60435-5463
Phone (815) 370-8822
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.028991 | IL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1710754619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 GLENWOOD AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355463",
"telephone_number": "815-370-8822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 GLENWOOD AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355463",
"telephone_number": "815-370-8822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCEO",
"first_name": "KYLIE",
"middle_name": "MARISSA",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-11",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.028991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.