Healthcare Provider Details

I. General information

NPI: 1659268696
Provider Name (Legal Business Name): SAREO ALI OSMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 W EDGERTON AVE APT 218
MILWAUKEE WI
53220-4850
US

IV. Provider business mailing address

4909 W EDGERTON AVE APT 218
MILWAUKEE WI
53220-4850
US

V. Phone/Fax

Practice location:
  • Phone: 402-987-4169
  • Fax:
Mailing address:
  • Phone: 402-987-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number02557819950100
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: