Christopher Michael Myslicki, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.009531 Issued in IL

Practice address

133 Spinder Dr
East Peoria, IL 61611-0016

Phone

(309) 308-5100

NPI assigned

Oct 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illinois Emergency Medicine Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bolingbrook, IL
  • NPI 1003150962
  Medicare reassignment
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1633737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1730841412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015099",
            "telephone_number": "630-865-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SPINDER DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616110016",
            "telephone_number": "309-308-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 University Ave",
            "address_purpose": "LOCATION",
            "city": "Dubuque",
            "state": "IA",
            "postal_code": "520015099",
            "country_code": "US",
            "telephone_number": "630-865-6533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYSLICKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-09",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Mosier
• Mueller Pediatric Therapy LTD
• Mueller Pediatric Therapy, LTD.
• Erin Nicole Lynette Mueller, M.S., CCC-SLP-L
• Nancy Murphy, M.A.
• Thomas R Nalepka, D.D.S.
• Megan Nikole Nauman, M.A., CCC-SLP/L
• Kellie Nedell
• Rebecca S Nell
• Briana Nesbit, LPN

• Physician Assistant in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.