Active NPI
Jane Ellen Harris Domingo, M.S., CCC-SLP
- Speech-Language Pathologist
- Chicago, IL
National Provider Identifier
1063683894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146006946
- Practice address
- 5333 N Sheridan Rd
Genesis Rehabilitation
Chicago, IL 60640-7371 - Phone
- (773) 271-5189
- Fax
- (773) 271-5109
- NPI assigned
- Mar 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146006946 | IL | Primary |
Addresses
Primary practice location
5333 N Sheridan Rd
Genesis Rehabilitation
Chicago, IL 60640-7371
Mailing address
1401 S California Ave
Schwab Rehabilitation Hospital
Chicago, IL 60608-1858
Phone (773) 522-6511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146006946 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1063683894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 S CALIFORNIA AVE",
"address_2": "SCHWAB REHABILITATION HOSPITAL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081858",
"telephone_number": "773-522-6511",
"fax_number": "773-522-5840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 N SHERIDAN RD",
"address_2": "GENESIS REHABILITATION",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407371",
"telephone_number": "773-271-5189",
"fax_number": "773-271-5109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGO",
"first_name": "JANE",
"middle_name": "ELLEN HARRIS",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146006946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.