Active NPI
Dominika Kowalski, PNP, MSN
- Pediatric Nurse Practitioner
- Waukegan, IL
National Provider Identifier
1144528431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209.008597
- Practice address
- 2400 Belvidere Rd
Waukegan, IL 60085-6165 - Phone
- (847) 377-8400
- NPI assigned
- Mar 10, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209.008597 | IL | Primary |
Addresses
Primary practice location
2400 Belvidere Rd
Waukegan, IL 60085-6165
Mailing address
79 Lakeview Pkwy
Barrington, IL 60010-1411
Phone (773) 988-4502
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)
- Enrolled
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.008597 | IL | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481241600000",
"number": "1144528431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 LAKEVIEW PKWY",
"city": "BARRINGTON",
"state": "IL",
"postal_code": "600101411",
"telephone_number": "773-988-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 BELVIDERE RD",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600856165",
"telephone_number": "847-377-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOWALSKI",
"first_name": "DOMINIKA",
"credential": "PNP, MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2016-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209.008597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.