Most Relevant Information
Provider Data
| NPI Number: | 1003493958 |
| Provider Name: | TRACY O OMOROGIEVA |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.022270 |
Most Important Dates
| Enumeration Date: | 03/26/2021 |
| Last Updated: | 12/23/2021 |
Provider Practice Location
17901 GOVERNORS HWY STE 206
HOMEWOOD
IL
604301146
Practice Location Phone/Fax
| Phone: | 7089604280 |
| Fax: |
Provider Mailing Location
17901 GOVERNORS HWY STE 206
HOMEWOOD
IL
604301146
Provider Mailing Phone/Fax
| Phone: | 7089600390 |
| Fax: |