Stefanie Dominik LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

STEFANIE DOMINIK LLC

Practice address

1968 W Winnemac Ave Unit 3
Chicago, IL 60640-2617

Phone

(773) 893-0265

NPI assigned

Aug 6, 2020

Last updated

Aug 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stefanie Dominik, LCSWNPI 1972164929

Title

Owner

Phone

(224) 612-0230

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stefanie Dominik, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1972164929
  NPD Authorized official

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1134739972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 W WINNEMAC AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402617",
            "telephone_number": "773-893-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 W WINNEMAC AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402617",
            "telephone_number": "773-893-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEFANIE DOMINIK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "DOMINIK",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-612-0230",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1972164929",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Elisabeta Stefan, M.D.
• Elizabeth Rose Stefancic, B.S.
• Michael Florian Stefancic, M.D.
• Steven James Stefani
• Amie Stefanich, LCSW
• Stefanie Maxwell, Psy.D., P.C.
• Kristina Noemi Stefanini
• Vasilios John Stefanis, MD
• Jennifer Stefankiewicz
• Margaret Stefanowski

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.