Alejandra Camacho, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209027965 Issued in IL

Practice address

1425 N Hunt Club Rd Ste 100
Gurnee, IL 60031-2632

Phone

(847) 548-2200

Fax

(847) 548-2865

NPI assigned

Nov 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Provida Health Center SC

  • Family Medicine Physician
  • Gurnee, IL
  • NPI 1881890333
  Medicare reassignment NPD

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1891568531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N HUNT CLUB RD STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312632",
            "telephone_number": "847-548-2200",
            "fax_number": "847-548-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N HUNT CLUB RD STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312632",
            "telephone_number": "847-548-2200",
            "fax_number": "847-548-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "ALEJANDRA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2024-02-06",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209027965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Patrick Bunting, PHARMD
• Susan M. Burrows, LCSW
• Erica Burton
• Robert Paul Cafe
• Stacy Lynne Calcagnino, MSOTR L
• Brianna Megan Carnley
• Selina M Carpenter, PAC
• Michael Angelo Carranza
• Emilio Carrillo, D.D.S.
• Adejimi O Carrington

• Family Nurse Practitioner in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.