Provider Demographics
NPI:1184140634
Name:RACANELLI, KATHERINE RAE (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:RAE
Last Name:RACANELLI
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3634
Mailing Address - Country:US
Mailing Address - Phone:630-856-8650
Mailing Address - Fax:
Practice Address - Street 1:911 N ELM ST STE 301
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3642
Practice Address - Country:US
Practice Address - Phone:630-986-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.016356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily