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

Individual provider Family Medicine Physician · NPI 1457573388

Nichole Mirocha, DO is a Family Practice in Springfield, Illinois. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2004, 22 years ago. Practices with Board of Trustees of Southern Illinois University, a 142-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
22
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
IL
In the registry since
2007
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

520 N 4th St
Springfield, IL 62702-5238
Phone: (217) 757-8100
Fax: (217) 747-1351
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (IL)

Record details

NPI number1457573388
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 2, 2007
Last updated in NPPESOctober 16, 2007
Mailing addressPo Box 19639, Springfield, IL 62794-9639

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2004 (22 years in practice)
Group practice Board Of Trustees Of Southern Illinois University — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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