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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MIHAILO NIKOLIC
NPI 1013744879
Nurse Anesthetist, Certified Registered in Peoria, IL

Active since September 16, 2024
221 NE GLEN OAK AVE, PEORIA, IL 61636(309) 672-5654(309) 672-5735 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mihailo Nikolic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIHAILO NIKOLIC (NPI 1013744879) is an individual nurse anesthetist, certified registered in Peoria, Illinois, licensed in Illinois (209035930) and active in the NPI registry since September 2024. He maintains a secondary practice location in Tupelo.

NPPES Registry Identity

NPI1013744879
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMIHAILO NIKOLIC
Location Address221 NE GLEN OAK AVEPeoria, IL 61636-1000
Mailing Address1616 Pecan GrvTupelo, MS 38801-7182
Phone(309) 672-5654
Fax(309) 672-5735
Sole ProprietorNo
Enumeration DateSeptember 16, 2024
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1013744879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in IL · 209035930
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
221 NE GLEN OAK AVE, Peoria, IL 61636
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Secondary Practice Location 1

Location 11616 Pecan GrvTupelo, MS 38801-7182 · Phone (662) 321-3793

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRYCE HAMAMOTO
Student in an Organized Health Care Education/Training Program
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
RIAZ SHAH MD
Internal Medicine
221 NE GLEN OAK AVE, SUITE 504
PEORIA, IL 61636
Peoria County (309) 672-5729
CENTRAL ILLINOIS RADIATION ONCOLOGY PHYSICIANS, LTD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5700
WAQAS ALI MD
Internal Medicine
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
ANNE LOOK APN
Nurse Practitioner (Acute Care)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
DR. KENNETH STRUM M.D.
Anesthesiology
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 369-1761
DR. ANDREW BRIAN ARMSTRONG M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-4920
DR. MATTHEW TRENT CARPENTER MD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE, DEPARTMENT OF RADIATION ONCOLOGY
PEORIA, IL 61636
Peoria County (309) 672-5700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mihailo Nikolic's NPI number?

The NPI number for Mihailo Nikolic is 1013744879. It was assigned to this individual provider in the NPPES registry on September 16, 2024.

Where is Mihailo Nikolic located?

Mihailo Nikolic practices at 221 NE Glen Oak Ave, Peoria, IL 61636. The listed phone number is (309) 672-5654.

What is Mihailo Nikolic's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Mihailo Nikolic was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.