Provider Demographics
NPI:1891302956
Name:ACETO, ANTHONY CARMINE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CARMINE
Last Name:ACETO
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 S WEBER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-7500
Mailing Address - Country:US
Mailing Address - Phone:331-757-1881
Mailing Address - Fax:
Practice Address - Street 1:780 S WEBER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-7500
Practice Address - Country:US
Practice Address - Phone:331-757-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009319363LF0000X
IL209.022435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL309017639OtherCONTROLLED SUBSTANCE