Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mihailo Nikolic

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1013744879

Mihailo Nikolic is a Certified Registered Nurse Anesthetist (CRNA) in Peoria, Illinois. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

221 NE Glen Oak Ave
Peoria, IL 61636-1000
Phone: (309) 672-5654
Fax: (309) 672-5735
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1616 Pecan Grv, Tupelo, MS 38801-7182 — (662) 321-3793

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 209035930 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1013744879
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 16, 2024
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026
Mailing address1616 Pecan Grv, Tupelo, MS 38801-7182

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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