Dimitrina Vizinas, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036138515 Issued in IL

Practice address

1440 Renaissance Dr Ste 300
Park Ridge, IL 60068-1471

Phone

(847) 254-9714

Fax

(847) 803-1806

NPI assigned

Mar 26, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 25, 2019 through Oct 25, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1043586852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 300",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681356",
            "telephone_number": "847-207-8593",
            "fax_number": "847-803-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 300",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681471",
            "telephone_number": "847-254-9714",
            "fax_number": "847-803-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZINAS",
        "first_name": "DIMITRINA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036138515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "036138515",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francis Villanueva, DO
• Lisa Marie Villanueva, M.D.
• Sandy Villanueva
• Ruth E Vincent, LCPC, NCC
• Ravjot Kaur Virdi
• Nancy L Vogg
• Alina I Voica
• Joanne Volden, MD
• Von Parangalan
• John Vondran

• Family Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.