MRS. DOMINNO CAROLINE FOGLE (NPI# 1255615365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255615365 |
| Entity Type | Individual |
| Full Name | MRS. DOMINNO CAROLINE FOGLE |
| Credential | M.M.S., PA-C |
| Practice Address |
1300 Franklin Ave Suite 100 Normal IL 61761-3592 |
| Practice Telephone | 3092683761 |
| Mailing Telephone | 3092683761 |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2012-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085004161 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1300 FRANKLIN AVE SUITE 100 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164422663 | Timothy J Buffey | Family Medicine | 1300 Franklin Ave, Suite 100, Normal, IL 61761-3592 | 2005-07-26 |
| 1184117038 | Paul Jene Gustin | Neurological Surgery | 1300 Franklin Ave, Normal, IL 61761-3592 | 2018-06-14 |
| 1093174690 | Jessica Sinks | Nurse Practitioner | 1300 Franklin Ave, Suite 380, Normal, IL 61761-3592 | 2016-02-11 |
| 1720460025 | Matthew James Putty | Neurological Surgery | 1300 Franklin Ave, Suite 110, Normal, IL 61761-3592 | 2015-06-23 |
| 1508247370 | Michael Young | Neurological Surgery | 1300 Franklin Ave, Suite 110, Normal, IL 61761-3592 | 2015-06-17 |
| 1639585920 | John Christopher Hawkins II | Neurological Surgery | 1300 Franklin Ave, Suite 110, Normal, IL 61761-3592 | 2014-07-07 |
| 1154736452 | Summer Mustafa Hassan | Family Medicine | 1300 Franklin Ave, Suite #110, Normal, IL 61761-3592 | 2014-06-25 |
| 1861807174 | Evan Krueger | Neurological Surgery | 1300 Franklin Ave, Suite 110, Normal, IL 61761-3592 | 2014-06-25 |
| 1982045209 | Gurpreet Singh | Internal Medicine | 1300 Franklin Ave, Suite 380, Normal, IL 61761-3592 | 2013-07-15 |
| 1861756728 | Daniel William Gibson | Family Medicine | 1300 Franklin Ave, Pob Suite #100, Normal, IL 61761-3592 | 2012-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992984975 | Marilyn Snook | Physician Assistant | 1300 Franklin Ave, Suite 230-c, Normal, IL 61761-3588 | 2007-10-26 |
| 1598705428 | Andrew Button | Physician Assistant | 1302 Franklin Ave, #4500, Normal, IL 61761-3551 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
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| 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.