Healthcare Provider Details

I. General information

NPI: 1861342156
Provider Name (Legal Business Name): FRANCIS OMORODION OSAZUWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E DIEHL RD STE 440
NAPERVILLE IL
60563-1358
US

IV. Provider business mailing address

21852 W KNOLLWOOD DR
PLAINFIELD IL
60544-7046
US

V. Phone/Fax

Practice location:
  • Phone: 630-225-7519
  • Fax:
Mailing address:
  • Phone: 773-798-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.034492
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.454328
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: