Provider Demographics
NPI:1750335006
Name:OSMAN, MEHANA A (PT, MS, OCS)
Entity type:Individual
Prefix:
First Name:MEHANA
Middle Name:A
Last Name:OSMAN
Suffix:
Gender:M
Credentials:PT, MS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3742 HOME AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3922
Mailing Address - Country:US
Mailing Address - Phone:708-788-6139
Mailing Address - Fax:708-788-6101
Practice Address - Street 1:2738 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5247
Practice Address - Country:US
Practice Address - Phone:773-292-9380
Practice Address - Fax:773-292-9381
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634847OtherBCBS
IL01634847OtherBCBS