Doctor profile · Federal record
Dr. Souphaphone Nicksic, CRNA
Certified Registered Nurse Anesthetist (CMS: Certified Registered Nurse Anesthetist (CRNA)) · Certified Registered Nurse Anesthetist · Elgin, IL
- NPI 1740425701
- Accepts Medicare
- MIPS 93.1 / 100 · 2023
- 17 yrs in practice
- Licensed in 2 states
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 3 locations .
- Primary practice
-
1425 N Randall RD
Elgin, IL 601232300
(224) 783-1065
fax (224) 783-2852 - Additional location
-
2475 Dean St
Saint Charles, IL 601754831
(630) 584-9800 - Additional location
-
2600 Greenbush St
Lafayette, IN 479042477
(765) 448-8000 - Mailing address
-
29373 Network Pl
Chicago, IL 606731293
Credentials & registration
- NPI registered
- December 2008 — 18 yrs on file
- Profile last updated
- August 30, 2023
- Year of graduation
- 2009 — 17 yrs since
- Specialty taxonomy
- 367500000X — NUCC code
- State licenses (2)
- Illinois #209008677 · Indiana #28181986A
- Medicaid
- IN #200949460
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1740425701. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
47
Distinct HCPCS
2
Medicare allowed
$3,132
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
00142 |
Anesthesia for lens surgery | 33 | 33 | $64 | |
00812 |
Anesthesia for exam of colon using an endoscope | 14 | 14 | $73 |
In context: peer comparison
Among 5 peers in this city , average services per provider: 16. This provider delivers 2.9× the peer median.Frequently asked questions
What is Dr. Souphaphone Nicksic's medical specialty?
Dr. Souphaphone Nicksic practices Certified Registered Nurse Anesthetist in Elgin, IL.
Where does Dr. Souphaphone Nicksic practice?
Dr. Souphaphone Nicksic practices at 1425 N Randall RD, Elgin, IL 601232300. Office phone: 2247831065.
What is Dr. Souphaphone Nicksic's NPI?
Dr. Souphaphone Nicksic's National Provider Identifier (NPI) is 1740425701, issued by NPPES.
Does Dr. Souphaphone Nicksic accept Medicare assignment?
Yes. Dr. Souphaphone Nicksic accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Souphaphone Nicksic commonly perform?
Top Medicare-reported procedures in 2023: Anesthesia for lens surgery (HCPCS 00142); Anesthesia for exam of colon using an endoscope (HCPCS 00812). Source: CMS Medicare Physician & Other Practitioners file.