Individual provider Active NPI

Jennifer Louise Mihailovic, APN

  • Family Nurse Practitioner
  • Mount Prospect, IL
National Provider Identifier
1083959167
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.000208 Issued in IL
Practice address
640 E Northwest Hwy Ste 100
Mount Prospect, IL 60056-3307
Phone
(847) 942-1406
NPI assigned
Nov 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277.000208 IL Primary

Addresses

Primary practice location

640 E Northwest Hwy Ste 100
Mount Prospect, IL 60056-3307

Mailing address

515 Dover Dr
Des Plaines, IL 60018-5545
Phone (847) 942-1406

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130917000713 IL Practitioner - Nurse Practitioner 1254575046 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277.000208ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive OB SC CurrentSince Jun 26, 2020 Accepting new patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince Aug 16, 2013 Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

27750 W Il Route 22
Ste 120
Lake Barrington, IL 60010
Phone (847) 277-0500

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

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.

NPI Registry JSON

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1083959167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DOVER DR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600185545",
            "telephone_number": "847-942-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E NORTHWEST HWY STE 100",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563307",
            "telephone_number": "847-942-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHAILOVIC",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.000208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.