Healthcare Provider Details

I. General information

NPI: 1679817209
Provider Name (Legal Business Name): SUZANNE NICOLE OLESKO PHMNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE
CHICAGO IL
60602-1903
US

IV. Provider business mailing address

80 E MIDLOTHIAN BLVD
YOUNGSTOWN OH
44507-2019
US

V. Phone/Fax

Practice location:
  • Phone: 833-688-2274
  • Fax:
Mailing address:
  • Phone: 330-234-5251
  • Fax: 330-234-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0038484
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: