Provider Demographics
NPI:1881171296
Name:ORAHAM, TINA FRANCINE (FNP)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:FRANCINE
Last Name:ORAHAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 BEISNER RD STE 1509
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3475
Mailing Address - Country:US
Mailing Address - Phone:847-631-5663
Mailing Address - Fax:
Practice Address - Street 1:955 BEISNER RD # 1509
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3475
Practice Address - Country:US
Practice Address - Phone:312-238-1751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily