Souphaphone Bounmythavong Nicksic, CRNA in Elgin, IL

Souphaphone Bounmythavong Nicksic, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Elgin, Illinois. Her current practice location is 1425 N Randall Rd, Elgin, Illinois. You can reach out to her office (for appointments etc.) via phone at (224) 783-1065.

Souphaphone Bounmythavong Nicksic is licensed to practice in Illinois (license number 209008677) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1740425701.

Contact Information

	Souphaphone Bounmythavong Nicksic, CRNA
	1425 N Randall Rd, Elgin, IL 60123-2300
	(224) 783-1065
	(224) 783-2852

Map and Direction

Provider's Profile

Full Name	Souphaphone Bounmythavong Nicksic
Gender	Female
Speciality
Experience	Years
Location	1425 N Randall Rd, Elgin, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Souphaphone Bounmythavong Nicksic attended and graduated from in

NPI Data:

NPI Number: 1740425701
Provider Enumeration Date: 12/04/2008
Last Update Date: 08/30/2023

Medicare PECOS Information:

PECOS PAC ID:
Enrollment ID:

Medical Identifiers

Medical identifiers for Souphaphone Bounmythavong Nicksic such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740425701	NPI	-	NPPES
000000610221	Other	IN	ANTHEM PROVIDER NUMBER
200949460	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	28181986A (Indiana)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	209008677 (Illinois)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Souphaphone Bounmythavong Nicksic is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Souphaphone Bounmythavong Nicksic, CRNA 29373 Network Pl, Chicago, IL 60673-1293 Ph: (847) 390-5900	Souphaphone Bounmythavong Nicksic, CRNA 1425 N Randall Rd, Elgin, IL 60123-2300 Ph: (224) 783-1065

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Elgin, IL

Janine A. Goodsite, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 77 N Airlite St, Elgin, IL 60123 Phone: 312-695-3200
James Redding, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1425 N Randall Rd, Elgin, IL 60123 Phone: 224-783-2932 Fax: 224-783-2032
Laura J Sostak, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 934 Center St, Elgin, IL 60120 Phone: 847-742-9800
Joan Young, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 77 N Airlite St, Elgin, IL 60123 Phone: 847-695-3200
Stacy Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 77 N Airlite St, Elgin, IL 60123 Phone: 847-695-3200
Steve Urbane, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 934 Center St, Elgin, IL 60120 Phone: 847-742-9800

Souphaphone Bounmythavong Nicksic, CRNA - Medicare in Elgin, IL