Individual provider Active NPI

Adelisa Omerovic, PA-C

  • Physician Assistant
  • Glenview, IL
National Provider Identifier
1750173753
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085012143 Issued in IL
Practice address
2100 Pfingsten Rd
Glenview, IL 60026-1301
Phone
(847) 657-5840
Fax
(847) 657-5732
NPI assigned
May 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085012143 IL Primary

Addresses

Primary practice location

2100 Pfingsten Rd
Glenview, IL 60026-1301

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1750173753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-657-5840",
            "fax_number": "847-657-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMEROVIC",
        "first_name": "ADELISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-19",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085012143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.