Provider Demographics
NPI:1881483386
Name:OSBORN, ELISKA (PMHNP)
Entity type:Individual
Prefix:
First Name:ELISKA
Middle Name:
Last Name:OSBORN
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4226 N ASHLAND AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4925
Mailing Address - Country:US
Mailing Address - Phone:765-418-6732
Mailing Address - Fax:765-418-6732
Practice Address - Street 1:4226 N ASHLAND AVE APT 4B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-4925
Practice Address - Country:US
Practice Address - Phone:765-418-6732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041442951163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse