Healthcare Provider Details

I. General information

NPI: 1194235283
Provider Name (Legal Business Name): MELISSA ANN ARANGOA MS,APN,ACNS-BC,AOCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA ANN GRZYBOWSKI BSN, RN

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date: 03/30/2018
Reactivation Date: 09/05/2019

III. Provider practice location address

5841 S. MARYLAND AVE, MC 1083
CHICAGO IL
60637
US

IV. Provider business mailing address

17906 ROY STREET
LANSING IL
60438
US

V. Phone/Fax

Practice location:
  • Phone: 773-926-1183
  • Fax: 773-702-8690
Mailing address:
  • Phone: 708-203-7356
  • Fax: 219-392-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041341525
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28167863A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number28167863A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number21867863A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number28167863A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number28167863A
License Number StateIN
# 7
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number28167863A
License Number StateIN
# 8
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License Number209.019740
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: