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NPI Code Detail

MEDICARE: TRACY O OMOROGIEVA APN-CNP

MEDICARE:   TRACY O OMOROGIEVA  APN-CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209.022270IL
2363L00000XNurse Practitioner209022270IL

General Provider Information

NPI Number : 1003493958
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY O OMOROGIEVA APN-CNP
Provider Business Mailing Address
First Line : 2650 RIDGE AVE # 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-982-3175
Fax Number : 847-982-3394
Provider Business Practice Location Address
First Line : 18W140 BUTTERFIELD RD FL 15
Second Line :
City : OAKBROOK TERRACE
State : IL
Zip : 60181-4843
Country : US
Telephone Number : 773-276-2655
Fax Number : 773-639-2346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2021
Last Update Date : 05/05/2026

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Directions to “ TRACY O OMOROGIEVA APN-CNP” Practice Location

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