Individual provider Active NPI

Paulina Michalik, APRN, CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1073132007
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209024528 Issued in IL
Practice address
675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone
(312) 695-8624
Fax
(312) 695-4741
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.471985 OH
Registered Nurse 163W00000X 041413256 IL
Family Nurse Practitioner 363LF0000X APRN.CNP.0027046 OH
Nurse Practitioner 363L00000X 209024528 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980

Mailing address

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone (312) 695-8624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201215003040 OH Practitioner - Nurse Practitioner 0446662407 Reassigns benefits to 1 organization
I20240129004071 IL Practitioner - Nurse Practitioner 0446662407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041413256ILMDRegistered Nurse
RN.471985OHMDRegistered Nurse
209024528ILMDNurse Practitioner
APRN.CNP.0027046OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Hospital CurrentSince Nov 11, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 15, 2024 Accepting new patients
Lutheran Hospital CurrentSince Nov 11, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 15, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 18-250
Chicago, IL 60611
Phone (312) 695-8624

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1730 W 25th St
Cleveland, OH 44113
Phone (216) 696-4300

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1073132007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115980",
            "telephone_number": "312-695-8624",
            "fax_number": "312-695-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115980",
            "telephone_number": "312-695-8624",
            "fax_number": "312-695-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALIK",
        "first_name": "PAULINA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.471985",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041413256",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0027046",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.