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AMANDA MICKLO DO
NPI 1619771508
Internal Medicine in Evanston, IL

Active since April 01, 2025PECOS Enrolled
2650 RIDGE AVE STE 1304, EVANSTON, IL 60201(847) 570-2700(847) 570-2822 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Amanda Micklo Do NPPES

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

AMANDA MICKLO DO (NPI 1619771508) is an individual internal medicine provider in Evanston, Illinois, licensed in Illinois (125.085423) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619771508
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameAMANDA MICKLOCredential: DO
Location Address2650 RIDGE AVE STE 1304Evanston, IL 60201-1700
Mailing Address180 Harvester Dr Ste 110Burr Ridge, IL 60527-6686 · (773) 702-1150
Phone(847) 570-2700
Fax(847) 570-2822
Sole ProprietorYes
Enumeration DateApril 1, 2025
Last NPPES UpdateJuly 15, 2025
NPPES CertifiedJuly 15, 2025
✔ NPI 1619771508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 125.085423
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2650 RIDGE AVE STE 1304, Evanston, IL 60201
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Micklo Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

EILEEN VERA
Student in an Organized Health Care Education/Training Program
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 666-3494
MARIANA MCCUNE MD
Student in an Organized Health Care Education/Training Program
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 570-2700
ISRA HASNAIN
Family Medicine
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 666-3494
ANDIE KWON MD
Dermatology
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 570-2700
DR. NICOLE RENEE PALMER MD, MPH
Student in an Organized Health Care Education/Training Program
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 570-1010
ERIC COOPER
Internal Medicine
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 570-2700
DR. OMKAR NITIN MORE MD
Student in an Organized Health Care Education/Training Program
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 570-2700
RICHARD WANG MD
Student in an Organized Health Care Education/Training Program
2650 RIDGE AVE STE 1304
EVANSTON, IL 60201
Cook County (847) 570-2700

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 Amanda Micklo's NPI number?

The NPI number for Amanda Micklo is 1619771508. It was assigned to this individual provider in the NPPES registry on April 1, 2025.

Where is Amanda Micklo located?

Amanda Micklo practices at 2650 Ridge Ave Ste 1304, Evanston, IL 60201. The listed phone number is (847) 570-2700.

What is Amanda Micklo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Amanda Micklo enrolled in Medicare?

Yes. Amanda Micklo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amanda Micklo was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.