Individual provider Active NPI

William E Schlicklin, ACNP

  • Acute Care Nurse Practitioner
  • Rochester, MI
National Provider Identifier
1083947006
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704222201 Issued in MI
Practice address
1101 W University Dr
Rochester, MI 48307-1863
Phone
(248) 652-5000
NPI assigned
Sep 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704222201 MI Primary

Addresses

Primary practice location

1101 W University Dr
Rochester, MI 48307-1863

Mailing address

4655 Edgewood St
Dearborn Heights, MI 48125-3229
Phone (734) 536-0415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250821000419 AZ Practitioner - Nurse Practitioner 3476687062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

5757 W Thunderbird Rd
Suite E456
Glendale, AZ 85306-4650
Phone (623) 476-5190

Hospital & facility affiliations

  • Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704222201MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 7, 2025 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 7, 2025 Accepting new patients

Locations

5757 W Thunderbird Rd
Ste E456
Glendale, AZ 85306
Phone (602) 843-1777

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

13943 N 91st Ave
Ste B101
Peoria, AZ 85381
Phone (623) 476-5190

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1083947006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 EDGEWOOD ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481253229",
            "telephone_number": "734-536-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY DR",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071863",
            "telephone_number": "248-652-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICKLIN",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704222201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.