Miriam Edith Keclik

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209026606 Issued in IL

Practice address

3901 Mercy Dr
McHenry, IL 60050-3151

Phone

(844) 599-3700

NPI assigned

Feb 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miriam Edith Hernandez Balbaneda Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: miriam.hernandezbalbaneda.p1@direct.gefcc.nextgenshare.com

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.

• Greater Family Health

  • Federally Qualified Health Center (FQHC)
  • Elgin, IL
  • NPI 1447381074
  NPD (past)
• Greater Family Health

  • Federally Qualified Health Center (FQHC)
  • Elgin, IL
  • NPI 1720142557
  NPD (past)

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1649978289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MERCY DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600503151",
            "telephone_number": "844-599-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MERCY DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600503151",
            "telephone_number": "844-599-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECLIK",
        "first_name": "MIRIAM",
        "middle_name": "EDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "HERNANDEZ BALBANEDA",
            "middle_name": "EDITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zachary James Karr, LCSW
• Ashley Kaszniak, RN
• Navneet Kaur, DDS
• Anusha Kavuri, MD
• Christopher Kearley
• Genevieve Joan Keefe
• James Keller
• Jennifer Keller
• Susan Kay Keller
• Jens P Kellermeier, M.D.

• Family Nurse Practitioner in McHenry, IL
• Providers in McHenry, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.