Healthcare Provider Details

I. General information

NPI: 1417885278
Provider Name (Legal Business Name): MELISA OSMANCEVIC RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 APPLE CREEK LN
DES PLAINES IL
60016-6717
US

IV. Provider business mailing address

15 BAR HARBOUR RD
SCHAUMBURG IL
60193-1907
US

V. Phone/Fax

Practice location:
  • Phone: 331-771-1963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number041449068
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: