Provider Demographics
NPI:1588461180
Name:OWITI, SYPROSE (APRN)
Entity type:Individual
Prefix:
First Name:SYPROSE
Middle Name:
Last Name:OWITI
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 S HIDDENBROOK TRL
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-9101
Mailing Address - Country:US
Mailing Address - Phone:813-481-8377
Mailing Address - Fax:
Practice Address - Street 1:1030 S HIDDENBROOK TRL
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-9101
Practice Address - Country:US
Practice Address - Phone:813-481-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.031755363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health