Angela L Miciura, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036.164827 Issued in IL

Practice address

750 E Terra Cotta Ave Ste B
Crystal Lake, IL 60014-3621

Phone

(815) 759-6363

Fax

(815) 759-6360

NPI assigned

Mar 22, 2018

Last updated

Jun 20, 2025By the provider in NPPES

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Surgical Oncology

Education

Michigan State University College of Human Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amiciura720426@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Illinois Medical Center

  dba Centegra Hospital McHenry

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1720582794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "815-759-6363",
            "fax_number": "815-759-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "815-759-6363",
            "fax_number": "815-759-6360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601025916",
            "country_code": "US",
            "telephone_number": "815-759-6363",
            "fax_number": "815-759-6360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICIURA",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.164827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Michael Meurlott, R.PH.
• Meagan Mevis, RBT
• Katherine Dale Meyer, M.S. CCC-SLP
• Michael T. Burns, Psy.D LTD
• John C Michael, MD
• Midwest Center for Childrens Development NFP
• Midwest Endocrinology LLC
• Midwest Home Medical Supplies, LTD.
• Midwest Lakes Medical Center, SC
• Midwest Physical Therapy Ctr

• Surgery Physician in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.