NPI 1013744879

Mihailo Nikolic

Practitioner Certified Registered Nurse Anesthetist Peoria, IL

Practice location

Address: 221 NE Glen Oak Ave, Peoria, IL 61636-1000
Phone: (309) 672-5654
Fax: (309) 672-5735
Mailing address: 1616 Pecan Grv, Tupelo, MS 38801-7182

Registered specialties (2)

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 209035930 (IL)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1013744879
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2024
Record last updated: 29 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.