MRS. DIANE LYNN DESTEFANO (NPI# 1063797314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063797314 |
| Entity Type | Individual |
| Full Name | MRS. DIANE LYNN DESTEFANO |
| Credential | APRN |
| Practice Address |
1123 Chestnut St Mount Carmel IL 62863-1212 |
| Practice Telephone | 6182634376 |
| Practice Fax Number | 6182627970 |
| Mailing Telephone | 6182634376 |
| Mailing Fax Number | 6182627970 |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2014-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
209009671 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | IN LICENSE | 71003775A | 01 |
| KY | KY LIC | 3007204 | 01 |
| IL | ILLINOIS APN LICENSE | 209009671 | 01 |
| Street Address |
1123 CHESTNUT ST |
| City | MOUNT CARMEL |
| State | IL |
| Zip Code | 62863-1212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215920756 | Narendra H Anadkat | Internal Medicine | 1123 Chestnut St, Mount Carmel, IL 62863-1212 | 2005-08-30 |
| 1255814018 | Brooke Nicole Ile | Nurse Practitioner | 1123 Chestnut St, Mount Carmel, IL 62863-1212 | 2018-09-07 |
| 1578012084 | Wabash General Hospital District | Clinic/Center | 1123 Chestnut St, Mount Carmel, IL 62863-1212 | 2016-09-26 |
| 1831509009 | Lauren Spencer Croft | Pediatrics | 1123 Chestnut St, Mount Carmel, IL 62863-1212 | 2014-04-28 |
| 1932224508 | Narendra H Anadkat M D P C | Internal Medicine | 1123 Chestnut St, Mount Carmel, IL 62863-1212 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295200319 | Beth Marie Fischer | Physician Assistant | 1527 College Dr., Mt. Carmel, IL 62863 | 2018-10-04 |
| 1386194744 | Kayla Marie Wilcox | Physician Assistant | 1527 College Drive, Mt. Carmel, IL 62863 | 2016-10-10 |
| 1144495961 | Karsten B Slater | Family Medicine | 1527 College Dr, Mount Carmel, IL 62863 | 2008-04-23 |
| 1417147760 | Keesha L. Peterson | Speech-Language Pathologist | 1418 College Drive, Physical Medicine Department, Mount Carmel, IL 62863 | 2007-08-01 |
| 1740488139 | Wabash Area Vocational Enterprises, Inc. | Day Training, Developmentally Disabled Services | 1420 West Third Street, Mt. Carmel, IL 62863 | 2007-07-06 |
| 1972649390 | David Ray Miller | Dentist | 325 East 13th Street, Mount Carmel, IL 62863 | 2007-01-30 |
| 1356406748 | Enrique V Bouffard IIi | Radiology | 326 West 3rd St, Mt Carmel, IL 62863 | 2006-12-26 |
| 1417028168 | General Baptist Nursing Home of Illinois | Skilled Nursing Facility | 1320 W. 9th Street, Mt. Carmel, IL 62863 | 2006-11-13 |
| 1316055130 | Richland Radiology Ltd | Clinic/Center | 326 W 3rd Street, Mount Carmel, IL 62863 | 2006-08-29 |
| 1760986392 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1418 College Dr, Mount Carmel, IL 62863 | 2018-03-20 |
| Find all providers in zip 62863 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759461 | Sarah Westerman | Nurse Practitioner | 721 Dover Ct, Pingree Grove, IL 60140-9181 | 2020-10-28 |
| 1609485424 | Intensive Karen LLC | Nurse Practitioner | 612 Mulford St Apt 503, Evanston, IL 60202-3531 | 2020-07-28 |
| 1609484591 | Jennifer Kuczero | Nurse Practitioner | 4059 W 89th Pl, Hometown, IL 60456-1202 | 2020-07-16 |
| 1205452489 | Aneta Trybula | Nurse Practitioner | 10604 W 154th Pl, Orland Park, IL 60462-6025 | 2020-06-23 |
| 1740742170 | Jenna C Reeh | Nurse Practitioner | 1740 W Taylor St # 605e, Chicago, IL 60612-7232 | 2019-04-04 |
| 1588125116 | Sherryl Estorque | Nurse Practitioner | 9033 W Heathwood Cir, Niles, IL 60714-5807 | 2019-03-27 |
| 1992276497 | Laura Beth Miller | Nurse Practitioner | 302 W Hay St Ste 110, Decatur, IL 62526-4167 | 2018-12-09 |
| 1932674322 | Ashleigh M Poptic | Nurse Practitioner | 675 N St Claire St Ste 19-100, Galter Pavilion, Chicago, IL 60611-5969 | 2018-10-11 |
| 1215415039 | Julieanne Ferguson | Nurse Practitioner | 251 E Huron St Dept Of, Chicago, IL 60611-2908 | 2018-08-02 |
| 1275024523 | Lateisha Nicole Fort | Nurse Practitioner | 1222 E 170th St, South Holland, IL 60473-3558 | 2018-05-22 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT CARMEL |
| Zip Code | 62863 |
Please comment or provide details below to improve the information on MRS. DIANE LYNN DESTEFANO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.