Individual provider Active NPI

Robert J Didomenico Jr., PHARM.D.

  • Pharmacotherapy Pharmacist
  • Chicago, IL
National Provider Identifier
1235210261
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
Practice address
833 S Wood St
M/C 886
Chicago, IL 60612-7229
Phone
(312) 996-0898
Fax
(312) 996-0379
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X IL Primary

Addresses

Primary practice location

833 S Wood St
M/C 886
Chicago, IL 60612-7229

Mailing address

833 S Wood St
M/C 886
Chicago, IL 60612-7229
Phone (312) 996-0898

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051040893ILMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235210261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 S WOOD ST",
            "address_2": "M/C 886",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127229",
            "telephone_number": "312-996-0898",
            "fax_number": "312-996-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 S WOOD ST",
            "address_2": "M/C 886",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127229",
            "telephone_number": "312-996-0898",
            "fax_number": "312-996-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDOMENICO",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IL",
            "license": null,
            "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 Jul 21, 2022; 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.