Provider Demographics
NPI:1073132007
Name:MICHALIK, PAULINA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:MICHALIK
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 18-250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5980
Mailing Address - Country:US
Mailing Address - Phone:312-695-8624
Mailing Address - Fax:312-695-4741
Practice Address - Street 1:675 N SAINT CLAIR ST STE 18-250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5980
Practice Address - Country:US
Practice Address - Phone:312-695-8624
Practice Address - Fax:312-695-4741
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.471985163W00000X
IL041413256163W00000X
OHAPRN.CNP.0027046363LF0000X
IL209024528363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily