MRS. DIANE LYNN DESTEFANO (APRN) – Acute Care Nurse Practitioner, NPI 1063797314

MRS. DIANE LYNN DESTEFANO (APRN) is a healthcare provider. based in Mount carmel, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 209009671 (IL). The NPI Number for MRS. DIANE LYNN DESTEFANO (APRN) is 1063797314

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
MRS. DIANE LYNN DESTEFANO (APRN)
NPI
1063797314
Phone
(618) 263-4376
Address
1123 CHESTNUT ST
Enumeration Date
19 October 2011
Last Update Date
10 June 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6183757101
Graduation Year
2011 (15 years ago)
PAC ID
2264606995
Group Practice PAC ID
8022908185
Professional Enrollment ID
I20130328000349
Address ID
IL628441002GR610XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MRS. DIANE LYNN DESTEFANO (APRN)

  • 1123 CHESTNUT ST

    MOUNT CARMEL, IL 628631212

    Phone: (618) 263-4376

    Fax: (618) 262-7970

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2023-11-07 • Largest payer in this snapshot: ABBVIE INC. ($16).

Total Amount

$30

General + Research + Ownership

Payments

2

Total payment records

General Amount

$30

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$16
Novo Nordisk Inc$14
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-03-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130328000349INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62863)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022908185View full group profile
NameSpecialtyState
Family PracticeNM
Nurse PractitionerIL
General SurgeryIN
Nurse PractitionerME
Nurse PractitionerIL
Family PracticeIL
-IN
Nurse PractitionerIL
Nurse PractitionerIL
General SurgeryTN

Reviews

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Frequently asked questions

What is the registry number for MRS. DIANE LYNN DESTEFANO (APRN)?
The registry entry for MRS. DIANE LYNN DESTEFANO (APRN) shows NPI 1063797314.
Does the public listing show MRS. DIANE LYNN DESTEFANO (APRN) as active?
MRS. DIANE LYNN DESTEFANO (APRN)'s NPI record reflects an active status in NPPES.
Which specialty label fits MRS. DIANE LYNN DESTEFANO (APRN)?
NPPES ties MRS. DIANE LYNN DESTEFANO (APRN) to Acute Care Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is MRS. DIANE LYNN DESTEFANO (APRN) tied to Mount Carmel, Illinois?
If you are local to Mount Carmel, Illinois, MRS. DIANE LYNN DESTEFANO (APRN) may be relevant to your search.
Who maintains MRS. DIANE LYNN DESTEFANO (APRN)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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