Mikulich, Sandra Lynn

Mikulich, Sandra Lynn is an individual health care provider with primary practice located at 17850 Kedzie Ave Ste 3250 , Hazel Crest IL 60429-2082. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mikulich, Sandra Lynn can be contacted via phone (708) 799-8700.

Contact Information

Primary practice address
17850 Kedzie Ave Ste 3250 Hazel Crest IL 60429-2082
Phone: (708) 799-8700
Fax: (708) 957-1830
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209007221 Illinois

Profile Details

NPI number 1528216082
LBN Legal business name Mikulich, Sandra Lynn
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2008
Last updated Jan 13th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528216082 NPPES
Illinois Other 3160176976 BLUE CROSS
Illinois Other CM7411 BLUE CROSS
Illinois Other P00694835 BLUE CROSS

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