Provider Demographics
NPI:1194235283
Name:ARANGOA, MELISSA ANN (MS,APN,ACNS-BC,AOCNS)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:ARANGOA
Suffix:
Gender:F
Credentials:MS,APN,ACNS-BC,AOCNS
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:GRZYBOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:17906 ROY STREET
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438
Mailing Address - Country:US
Mailing Address - Phone:708-203-7356
Mailing Address - Fax:219-392-7408
Practice Address - Street 1:5841 S. MARYLAND AVE, MC 1083
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-926-1183
Practice Address - Fax:773-702-8690
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2019-09-05
Deactivation Date:2018-03-30
Deactivation Code:
Reactivation Date:2019-09-05
Provider Licenses
StateLicense IDTaxonomies
IL041341525163W00000X
IN28167863A163W00000X, 163WW0000X, 364S00000X, 364SA2100X, 364SA2200X
IN21867863A163WX1500X
IL209.019740364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
No163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health