Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ezequiel R Mora, APRNFNP-BC

Individual provider Family Nurse Practitioner · NPI 1912641879

Ezequiel R Mora, APRNFNP-BC is a Nurse Practitioner in Sycamore, Illinois. Qualified in 2021, 5 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

954 W State St
Sycamore, IL 60178-1335
Phone: (815) 895-9144
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209.025250 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 041.408204 (IL)

Record details

NPI number1912641879
Entity typeIndividual (Type 1)
GenderMale
Credentials APRNFNP-BC
Sole proprietorNo
NPI enumeratedApril 26, 2022
Last updated in NPPESMay 27, 2022
Certification dateMay 27, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Sycamore