Individual provider Active NPI

Daniel Domoleczny, L.AC.

  • Acupuncturist
  • Northfield, IL
National Provider Identifier
1194175687
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198.001315 Issued in IL
Practice address
193 Northfield Rd
Northfield, IL 60093-3309
Phone
(773) 454-3922
NPI assigned
Jun 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198.001315 IL Primary

Addresses

Primary practice location

193 Northfield Rd
Northfield, IL 60093-3309

Mailing address

193 Northfield Rd
Northfield, IL 60093-3309
Phone (773) 454-3922

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

State licenses

LicenseStateTypeSpecialty
198.001315ILMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1194175687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 NORTHFIELD RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933309",
            "telephone_number": "773-454-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 NORTHFIELD RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933309",
            "telephone_number": "773-454-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMOLECZNY",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198.001315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.

Verify at the official NPI Registry.