MEDICARE: MS. STEPHANIE RANCICH DNP, FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	209033065	IL

General Provider Information

NPI Number	:	1528948643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE RANCICH DNP, FNP-BC

Provider Business Mailing Address
First Line	:	659 W RANDOLPH ST APT 708
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-2168
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1044 N MOZART ST
Second Line	:	POB 100
City	:	CHICAGO
State	:	IL
Zip	:	60622
Country	:	US
Telephone Number	:	773-292-8383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2025
Last Update Date	:	02/03/2026

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