Individual provider Active NPI

Michael B. Nemsick, M.D.

  • Anesthesiology Physician
  • Loves Park, IL
National Provider Identifier
1417696600
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036.175202 Issued in IL
Practice address
2202 Harlem Road
Loves Park, IL 61111-2701
Phone
(815) 877-4848
Fax
(815) 654-5342
NPI assigned
Jun 3, 2022
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036.175202 IL Primary

Addresses

Primary practice location

2202 Harlem Road
Loves Park, IL 61111-2701

Mailing address

2202 Harlem Road
Loves Park, IL 61111-2701
Phone (815) 877-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-080333ILMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1417696600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 HARLEM ROAD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112701",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 HARLEM ROAD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112701",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMSICK",
        "first_name": "MICHAEL",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2026-10-09",
        "certification_date": "2026-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.175202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

Verify at the official NPI Registry.