HAZEL DHATES ASUNIO DOMINGO (NPI# 1508253410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508253410 |
| Entity Type | Individual |
| Full Name | HAZEL DHATES ASUNIO DOMINGO |
| Credential | PA-C |
| Practice Address |
259 E Erie St Fl 16 Chicago IL 60611-2987 |
| Mailing Address |
676 N Saint Clair St Ste 2000 Chicago IL 60611-3147 |
| Practice Telephone | 3126955620 |
| Practice Fax Number | 3126950042 |
| Mailing Telephone | 3126954837 |
| Mailing Fax Number | 3126950042 |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2019-08-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.0007019 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 22 S Greene St, Baltimore, MD 212011544 | 4103285310 | 4103286878 |
| 259 E Erie St Fl 16, Chicago, IL 606112987 | 3126955620 | 3126950042 |
| Street Address |
259 E ERIE ST FL 16 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-2987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942291604 | Vitaliy Y. Poylin | Colon & Rectal Surgery | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2005-11-02 |
| 1558910265 | Jennifer A Carvajal | Nurse Practitioner | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2019-09-05 |
| 1134632334 | Mary Rouzer | Nurse Practitioner | 259 E Erie St Fl 16, Chicago, IL 60611 | 2017-11-09 |
| 1730565649 | Kathryn Noth Tomasino | Psychologist | 259 E Erie St Fl 16, Lavin Family Pavilion, Chicago, IL 60611-2987 | 2015-08-03 |
| 1124380332 | Alexandra Baumann | Internal Medicine | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2012-06-13 |
| 1972833796 | Jennifer Cai | Internal Medicine | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2009-12-29 |
| 1124253935 | Anne M Stey | Surgery | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2009-05-22 |
| 1770511404 | Richard Green | Internal Medicine | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470709 | Bryan Ying Wong | Physician Assistant | 3420 S Morgan St Apt 2e, Chicago, IL 60608-6904 | 2020-09-04 |
| 1245858117 | Emily Victoria Headley | Physician Assistant | 1431 N Western Ave Ste 134, Chicago, IL 60622-1797 | 2020-07-08 |
| 1548884547 | Crystal Afua Amoah | Physician Assistant | 1665 N Orchard St Apt 104, Chicago, IL 60614-5385 | 2020-06-04 |
| 1841814274 | Zubair Aslam Khan | Physician Assistant | 3037 W Wilson Ave Apt 2w, Chicago, IL 60625-4345 | 2020-06-01 |
| 1659991818 | Taylor Nicole Anderson | Physician Assistant | 25 W Randolph St Apt 603, Chicago, IL 60601-3514 | 2020-04-17 |
| 1720616444 | Melanie Doretti | Physician Assistant | 3052 N Seminary Ave Apt 2r, Chicago, IL 60657-6788 | 2020-03-29 |
| 1154958544 | Joerissa Gearlds | Physician Assistant | 5645 W Addison St Rm 353, Chicago, IL 60634-4403 | 2020-03-25 |
| 1932736816 | Taylor Evan Fisher | Physician Assistant | 3033 N Sheridan Rd Apt 301, Chicago, IL 60657-5578 | 2020-03-23 |
| 1285260844 | Krista A Saum | Physician Assistant | 661 W Sheridan Rd Apt 601, Chicago, IL 60613-3311 | 2020-03-16 |
| 1386278430 | Adara Simonelli | Physician Assistant | 6317 S Lorel Avenue, Chicago, IL 60638 | 2020-02-27 |
| Find all providers in CHICAGO | ||||
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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.