Active NPI
Sandra Lynn Mikulich, APN
- Nurse Practitioner
- Hazel Crest, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209007221
- Practice address
- 17850 Kedzie Ave Ste 3250
Hazel Crest, IL 60429-2082 - Phone
- (708) 799-8700
- Fax
- (708) 957-1830
- NPI assigned
- Sep 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209007221 | IL | |
| Nurse Practitioner | 363L00000X | 209007221 | IL | Primary |
Addresses
Primary practice location
17850 Kedzie Ave Ste 3250
Hazel Crest, IL 60429-2082
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Other practice location 1
17800 South Kedzie Avenue
Hazel Crest, IL 60429
Phone (708) 213-3976
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3160176976 | Other | IL | BLUE CROSS |
| CM7411 | Other | IL | RAILROAD MEDICARE |
| P00694835 | Other | IL | RAILROAD MEDICARE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | smikulich221455@direct.myadvocateaurora.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 684-5340
17850 Kedzie Ave
Suite 3500
Hazel Crest, IL 60429-2082
Phone (708) 575-4415
214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209007221 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
17850 Kedzie Ave
Ste 3250
Hazel Crest, IL 60429
Phone (708) 779-8700
17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200
16300 Wausau Ave
South Holland, IL 60473
Phone (708) 596-5500
Interoperability endpoints
- smikulich221455@direct.myadvocateaurora.org
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hazel Crest, IL
- NPI 1467560128
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1558479212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741219200000",
"number": "1528216082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17850 KEDZIE AVE STE 3250",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292082",
"telephone_number": "708-799-8700",
"fax_number": "708-957-1830"
}
],
"practiceLocations": [
{
"address_1": "17800 South Kedzie Avenue",
"address_purpose": "LOCATION",
"city": "Hazel Crest",
"state": "IL",
"postal_code": "60429",
"country_code": "US",
"telephone_number": "708-213-3976",
"fax_number": "708-213-0213",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIKULICH",
"first_name": "SANDRA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-08",
"last_updated": "2025-03-06",
"certification_date": "2025-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209007221",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209007221",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "3160176976",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CM7411",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00694835",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "17850 Kedzie Ave Ste 3250",
"city": "Hazel Crest",
"state": "IL",
"country_code": "US",
"postal_code": "604292082",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "smikulich221455@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "17850 Kedzie Ave Ste 3250",
"city": "Hazel Crest",
"state": "IL",
"country_code": "US",
"postal_code": "604292082",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hazel Crest, IL
- Marjorie Ginou Michel, M.D.
- Midwest Anesthesia and Pain Specialists SC
- Midwest Diagnostics Inc
- Midwest Family and Community Resources PC
- Midwest Family and Community Resources PC
- Melanie Doreen Miller, M.A.
- Mindful Expressions PLLC
- Gina M Minga, APRN, ACCNS-BC
- Gerald J Mingolelli, MD
- Mariam Tariq Mir, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.