Individual provider Active NPI

Rosiland Sedlacek

  • Psychiatric/Mental Health Nurse Practitioner
  • Murphysboro, IL
National Provider Identifier
1265220651
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209029259 Issued in IL
Practice address
PO Box 851
Murphysboro, IL 62966-0851
Phone
(999) 999-9999
NPI assigned
Apr 28, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209029259 IL Primary

Addresses

Primary practice location

PO Box 851
Murphysboro, IL 62966-0851

Mailing address

PO Box 851
Murphysboro, IL 62966-0851

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
I20250626000208 IL Practitioner - Nurse Practitioner 0648782490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promed Preferred Il 2 PLLCGroup PAC ID 3870028251, 14 clinicians

Practice addresses (Care Compare)

141 Market PL
Suite 100
Fairview Heights, IL 62208-2089
Phone (618) 398-4226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209029259ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Preferred Il 2 PLLC Psychiatric/Mental Health CurrentSince Aug 29, 2025 Accepting new patients
Clinical Research Associates, PC CurrentSince May 1, 2025 Accepting new patients

Locations

141 Market Pl
Ste 100
Fairview Hts, IL 62208
Phone (618) 398-4226

6301 Humbert Rd
Godfrey, IL 62035
Phone (618) 446-0367

2044 Madison Ave
Ste G2
Granite City, IL 62040
Phone (314) 549-8494

1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1265220651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629660851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 851",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629660851",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLACEK",
        "first_name": "ROSILAND",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murphysboro, IL

Sources for this page

Verify at the official NPI Registry.