Mihailo Nikolic

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209035930 Issued in IL

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-1000

Phone

(309) 672-5654

Fax

(309) 672-5735

NPI assigned

Sep 16, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1013744879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 PECAN GRV",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388017182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616361000",
            "telephone_number": "309-672-5654",
            "fax_number": "309-672-5735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 Pecan Grv",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388017182",
            "country_code": "US",
            "telephone_number": "662-321-3793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKOLIC",
        "first_name": "MIHAILO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209035930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Scott Nickerson
• Sparkle L Nicks
• Lisa K Nielsen, PA-C
• Nalleli Monserrat Nieto
• Sarah Enid Nieves, D.C.
• J D Nimrick, PT
• John B Nixon
• Megan Nixon
• Anene Nnajiego Achebe, APRN,CNP
• Jennifer Marie Noar, LCPC

• Certified Registered Nurse Anesthetist in Peoria, IL
• Providers in Peoria, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.