Olivia Domczewski, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009871 Issued in IL

Practice address

2340 S Highland Ave Ste 210
Lombard, IL 60148-7132

Phone

(815) 416-6725

NPI assigned

Oct 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Domczewski Behavioral Medicine and Consultation PLLC

  • Psychologist
  • Hanover Park, IL
  • NPI 1659228922

  Clinical

  NPD Authorized official
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD

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

{
    "created_epoch": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1164997490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770264",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 S HIGHLAND AVE STE 210",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487132",
            "telephone_number": "815-416-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMCZEWSKI",
        "first_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-13",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "odomczewski213605@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "2340 S Highland Ave Ste 210",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601487132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• DMG Surgical Center LLC
• Doctor in the House Inc
• Mark G Doll, DDS
• Scott A. Dollinger, PSY.D.
• Leslie Dombrowski
• Nayeli Dominguez
• Megan Elizabeth Donnelly, PHD
• Charlotte Donoho
• Kailyn Donovan, LCSW
• Doris Ann Dornberger

• Clinical Psychologist in Lombard, IL
• Providers in Lombard, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.