Issac Pedro Domenech-Gonzalez

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

125082944 Issued in IL

Practice address

251 E Huron St
Chicago, IL 60611-2908

Phone

(502) 298-1310

NPI assigned

Apr 11, 2022

Last updated

Aug 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1033851951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 W CHICAGO AVE APT 2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224821",
            "telephone_number": "502-298-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "502-298-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENECH-GONZALEZ",
        "first_name": "ISSAC",
        "middle_name": "PEDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2023-08-18",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125082944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Joseph Dombrowski, LCPC
• James Michael Dombrowski, M.D.
• Lindsay Dombrowski, PSYD
• Kristen Dome, LPC
• Natalie Nicole Domek, DPM
• Courtney K Domenico, PSYD
• Shiori Domenighetti
• Brian Domin, DPT
• Madison Domin, PA
• Dominador L. Dayon Jr., M.D.S.C.

• Obstetrics & Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.