Provider Demographics
NPI:1639995459
Name:NIKOLOVA, SYLVIA (NP)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:NIKOLOVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:LUPINSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1270 NORTHLAND DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1189
Mailing Address - Country:US
Mailing Address - Phone:651-447-5975
Mailing Address - Fax:833-453-1564
Practice Address - Street 1:1440 W TAYLOR ST STE 2617
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4623
Practice Address - Country:US
Practice Address - Phone:651-447-5975
Practice Address - Fax:833-453-1564
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209030751363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily