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DR. STACEY L BOETTO DNP, FNP-C
NPI 1104334945
Nurse Practitioner in Chicago, IL

Active since January 15, 2018
142 E ONTARIO ST STE 1200, CHICAGO, IL 60611(312) 535-9440 Get Directions Write a Review

NPPES record last updated: September 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 12, 2025, May 29, 2025, Jan 3, 2022 and 6 more (9 updates tracked since 2018).

About Dr. Stacey L Boetto Dnp, Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. STACEY L BOETTO DNP, FNP-C (NPI 1104334945) is an individual nurse practitioner in Chicago, Illinois, licensed in Illinois (277000185) and active in the NPI registry since January 2018. She maintains a secondary practice location in Shorewood.

NPPES Registry Identity

NPI1104334945
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameDR. STACEY L BOETTOCredential: DNP, FNP-C
Location Address142 E ONTARIO ST STE 1200Chicago, IL 60611-2750
Mailing Address142 E Ontario St Ste 1200Chicago, IL 60611-2750 · (312) 535-9440
Phone(312) 535-9440
Sole ProprietorYes
Enumeration DateJanuary 15, 2018
Last NPPES UpdateSeptember 12, 20259 updates tracked since enumeration
NPPES CertifiedMay 29, 2025
✔ NPI 1104334945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in IL · 277000185✔ Licensed in IL · 209.017015
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 209.017015 (IL)
142 E ONTARIO ST STE 1200, Chicago, IL 60611
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Secondary Practice Location 1

Location 1303 N Raven RdShorewood, IL 60404-9639 · Phone (815) 546-4575

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Boetto's NPI number?

The NPI number for Stacey Boetto is 1104334945. It was assigned to this individual provider in the NPPES registry on January 15, 2018.

Where is Stacey Boetto located?

Stacey Boetto practices at 142 E Ontario St Ste 1200, Chicago, IL 60611. The listed phone number is (312) 535-9440.

What is Stacey Boetto's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Stacey Boetto was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.