KENDRA MICKELSON
NPI 1992158356
Skilled Nursing Facility in Eureka, IL

Active since July 20, 2016
700 N MAIN ST, EUREKA, IL 61530(309) 467-9094(309) 467-9011 Get Directions Write a Review

NPPES record last updated: July 20, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kendra Mickelson NPPES

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

KENDRA MICKELSON (NPI 1992158356) is an individual skilled nursing facility provider in Eureka, Illinois, licensed in Illinois (0042424) and active in the NPI registry since July 2016.

NPPES Registry Identity

NPI1992158356
Entity TypeIndividualFemale
Primary Taxonomy314000000X
Provider Legal NameKENDRA MICKELSON
Location Address700 N MAIN STEureka, IL 61530-1085
Mailing Address700 N Main StEureka, IL 61530-1085 · (309) 467-9094 · Fax (309) 467-9011
Fax(309) 467-9011
Sole ProprietorYes
Enumeration DateJuly 20, 2016
NPI 1992158356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Licenses Licensed in IL · 0042424 Licensed in IL · 1694647
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
700 N MAIN ST, Eureka, IL 61530

Other Identifiers 5

Medicaid0042424IL
Other314000000XIL · Taxonomy Number
Medicare OSCAR/certification145431IL
Medicare PIN145431IL
Medicare UPIN145431IL

Other Providers at the Same Location NPPES 5

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

Physical Therapist
700 N MAIN ST
EUREKA, IL 61530
Occupational Therapy Assistant
700 N MAIN ST
EUREKA, IL 61530
Skilled Nursing Facility
700 N MAIN ST
EUREKA, IL 61530
Skilled Nursing Facility
700 N MAIN ST
EUREKA, IL 61530
Clinic/Center
700 N MAIN ST
EUREKA, IL 61530

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 Kendra Mickelson's NPI number?

The NPI number for Kendra Mickelson is 1992158356. It was assigned to this individual provider in the NPPES registry on July 20, 2016.

Where is Kendra Mickelson located?

Kendra Mickelson practices at 700 N Main St, Eureka, IL 61530. The listed phone number is (309) 467-9094.

What is Kendra Mickelson's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Kendra Mickelson was last updated on July 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.