CARLO DOMINGO (NPI# 1194251272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194251272 |
| Entity Type | Individual |
| Full Name | CARLO DOMINGO |
| Credential | AGNP-C |
| Practice Address |
4 N Deer Point Dr Ste 1002 Hainesville IL 60030-3814 |
| Mailing Address |
4 N Deer Point Dr. Ste 1002 Hainesville IL 60030-3814 |
| Practice Telephone | 8479460198 |
| Mailing Telephone | 8479460198 |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2019-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209.019378 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
209.019378 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720107188 | Carlo Tadeo Domingo | Social Worker | 1513 Cleveland Ave, Building 300, East Point, GA 30344-6947 | 2007-03-28 |
| Street Address |
4 N DEER POINT DR STE 1002 |
| City | HAINESVILLE |
| State | IL |
| Zip Code | 60030-3814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093175804 | Zigma Visiting Physician, LLC | General Practice | 4 N Deer Point Dr, 1002, Hainesville, IL 60030 | 2016-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
| 1992347892 | Pier London | Social Worker | 18640 Belivdere Rd., Grayslake, IL 60030 | 2019-10-11 |
| 1972156529 | Elizabeth Reeve | Counselor | 18640 Belvidere, Grayslake, IL 60030 | 2019-07-23 |
| 1144725987 | Michael Kraft | Family Medicine | 1475 E. Belvidere Road, Suite 385, Grayslake, IL 60030 | 2018-03-26 |
| 1255850780 | Megan B March | Speech-Language Pathologist | 33089 N Battershall Rd, Grayslake, IL 60030 | 2017-09-15 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1184163628 | Surprenant Chiropractic LLC | Clinic/Center | 1227 N Illinois Route 83, Suite A, Grayslake, IL 60030 | 2017-02-16 |
| 1700230976 | Camelot Care Centers, LLC. | Foster Care Agency | 34121 North Route 45, Suite 207, Grayslake, IL 60030 | 2016-04-14 |
| 1932560414 | Vital Therapeutics Inc | Physical Therapist | 34121 N Us 45, Suite 101, Grayslake, IL 60030 | 2016-03-11 |
| 1720466485 | Linda A Amundsen | Social Worker | 18640 W Belvidere Rd, Grayslake, IL 60030 | 2015-05-14 |
| Find all providers in zip 60030 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553472 | Nicholas Johnson | Nurse Practitioner | 8455 S Luella Ave, Chicago, IL 60617-1953 | 2020-09-23 |
| 1710592175 | Mary Maloney | Nurse Practitioner | 348 Westglen Dr, Glen Carbon, IL 62034-1002 | 2020-09-12 |
| 1134738800 | Benjamin Scott Hulfachor | Nurse Practitioner | 4143 N Central Park Ave Apt G, Chicago, IL 60618-2062 | 2020-07-28 |
| 1083222368 | Izolda Rosario | Nurse Practitioner | 501 W Lake St Ste 207, Elmhurst, IL 60126-1419 | 2020-07-22 |
| 1043832785 | Melanie Glander | Nurse Practitioner | 18357 Cowing Ct, Homewood, IL 60430-3332 | 2020-05-16 |
| 1699306902 | Ife Muyiwa-ojo | Nurse Practitioner | 729 E Carpenter St, Springfield, IL 62702-5321 | 2020-01-27 |
| 1962040345 | Doctors Orders Inc. | Nurse Practitioner | 5113 S Harper Ave Ste 2, Chicago, IL 60615-4119 | 2019-12-16 |
| 1801455993 | Parul Arora | Nurse Practitioner | 1717 W Congress Pkwy Ste 1125, Chicago, IL 60612-3809 | 2019-06-11 |
| 1891358222 | Kelly Jo Erke | Nurse Practitioner | 20830 N 1970 East Rd, Danville, IL 61834-6228 | 2019-04-22 |
| 1689136319 | Brittany Sue Borkowski | Nurse Practitioner | 5841 S Maryland Ave # W700, Chicago, IL 60637-1443 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
| City | HAINESVILLE |
| Zip Code | 60030 |
Please comment or provide details below to improve the information on CARLO DOMINGO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.