Mina Lee Acevedo, APRN
Individual provider Active NPI Nurse Practitioner · Glenview, IL
NPI 1972174688 · NPPES record last updated Jun 15, 2022
Key facts
- NPI
- 1972174688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209.023409 (IL)
- Practice address
- 2180 Pfingsten Rd # 2000
Glenview, IL 60026-1339 - Phone
- (847) 570-2570
- Fax
- (847) 570-2073
- NPI assigned
- Jul 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210811003699 | IL | Practitioner - Nurse Practitioner | 9436553526 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Endeavor Health Medical Group | Current |
Accepting new patients | |
| Endeavor Health Medical Group | Current | Accepting new patients |
Locations
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2180 Pfingsten Rd
#2000
Glenview, IL 60026
Phone (847) 503-4500
2180 Pfingsten Rd
Glenview, IL 60026
Phone (847) 503-1000
Interoperability endpoints
- macevedo148110@direct.luhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 209.023409 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209.023409 | IL | |
| Nurse Practitioner | 363L00000X | 209.023409 | IL | Yes |
Addresses
Primary practice location
2180 Pfingsten Rd # 2000
Glenview, IL 60026-1339
Mailing address
2180 Pfingsten Rd # 2000
Glenview, IL 60026-1339
Phone (847) 570-2570
Other practice location 1
4100 Cove Ln Apt D
Glenview, IL 60025-3552
Phone (773) 387-5049
Other practice location 2
2415 S Michigan Ave
Chicago, IL 60616-2301
Phone (708) 486-2600
Other providers in Glenview, IL
- Michelle Lynn Abraham
- Myriam Abrams
- Absolute Vision Inc.
- Sarah Abu-Ghannam
- Accelerated Rehabilitation Centers, LTD
- Janely Guadalupe Acosta
- Activemed Physical Therapy and Wellness, LLC
- Carol Adam-Sada
- Pamela Sue Adams Kammin
- Amanda Adams
All providers in Glenview, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.