Nicole Miroballi, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

209015669 Issued in IL

Practice address

17901 Governors Hwy Ste 102
Homewood, IL 60430-1145

Phone

(708) 888-8287

Fax

(708) 957-4519

NPI assigned

Jan 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL HMO C-SNP

Interoperability endpoints

• Direct secure messaging: nmiroballi166130@uchospital.direct-ci.com
• Direct secure messaging: nicolemiroballi@aua.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Uropartners LLC

  • Urology Physician
  • Glenview, IL
  • NPI 1073567905
  Medicare reassignment NPD
• Uropartners, LLC

  • Durable Medical Equipment & Medical Supplies
  • Geneva, IL
  • NPI 1659124683
  NPD
• Uropartners, LLC

  • Urology Physician
  • Park Ridge, IL
  • NPI 1114972965
  NPD (past)

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1013453281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY STE 102",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301145",
            "telephone_number": "708-888-8287",
            "fax_number": "708-957-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY STE 102",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301145",
            "telephone_number": "708-888-8287",
            "fax_number": "708-957-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROBALLI",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209015669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolemiroballi@uropart.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17901 Governors Hwy Ste 102",
            "city": "Homewood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604301145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Minds Empowered Counseling Services LLC
• Rachel Cortney Minkel
• Josephine Minnicino, MD
• Miracle Healthcare LLC
• Anna Zamora Mireles
• Mission Optical, Inc.
• Juanikee Mitchell, OT
• Mixed Inclusion
• Oluwadamilola Oluseyi Monehin
• John F. Moore, D.D.S.,M.S.

• Women's Health Nurse Practitioner in Homewood, IL
• Providers in Homewood, IL by specialty
• Women's Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.