Jessica Mikulecky, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009204 Issued in IL

Practice address

11800 S 75TH Ave
Third Floor
Palos Heights, IL 60463-1033

Phone

(708) 671-8440

Fax

(708) 671-8446

NPI assigned

Dec 27, 2013

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Miracare Neuro Behavioral Health, PC

  • Psychologist
  • Palos Heights, IL
  • NPI 1649329251
  NPD (past)

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1104247709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 S 75TH AVE",
            "address_2": "THIRD FLOOR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631033",
            "telephone_number": "708-671-8440",
            "fax_number": "708-671-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 S 75TH AVE",
            "address_2": "THIRD FLOOR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631033",
            "telephone_number": "708-671-8440",
            "fax_number": "708-671-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULECKY",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.009650",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon A Miehle, PSYD, LCPC
• Neil Joseph Mier, MD
• Zdravko Mijailovic
• Kristin Margaret Mikolite, L.C.P.C., C.A.D.C.
• Sarah Mikulaschek, NP
• Laura A Miller-Falls, LCSW
• Ann L Miller, APRN, CNS
• James C Miller, MD
• Samantha Marie Miller, APRN,CNP
• Miracare Neuro Behavioral Health, PC

• Clinical Psychologist in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.