NPIMap

Individual provider Active NPI

Dominic Gaziano, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1275699209
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36091770 Issued in IL
Practice address
2222 W Division St
Ste 320
Chicago, IL 60622-2717
Phone
(773) 342-1212
NPI assigned
Dec 27, 2006
Last updated
Jul 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36091770 IL Primary

Addresses

Primary practice location

2222 W Division St
Ste 320
Chicago, IL 60622-2717

Mailing address

2222 W Division St Ste 110
Chicago, IL 60622-3093
Phone (773) 252-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100608000860 IL Practitioner - Internal Medicine 9931239555 Reassigns benefits to 2 organizations
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2222 W Division St
Suite 110
Chicago, IL 60622-3093
Phone (773) 252-4848

4900 N Bernard St
Chicago, IL 60625-5146
Phone (773) 583-7130

4920 N Kenmore Ave
Chicago, IL 60640-3710
Phone (773) 769-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36091770ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Healthcare LLC CurrentSince Dec 31, 2023 Accepting new patients
Quality Plus Care Inc CurrentSince Jan 1, 2025 Accepting new patients
Evocare Wound Solutions PA CurrentSince Jan 1, 2025 Accepting new patients
Body and Mind Medical Internal Medicine PastSince Jan 15, 2010 Accepting new patients

Locations

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

400 N May St
Ste 101
Chicago, IL 60642
Phone (312) 498-6616

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

5635 W 96th St
Ste 300
Indianapolis, IN 46278
Phone (317) 733-9454

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Elevate Care Chicago NorthChicago, IL, CCN 145484 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2019
Dec 1, 2019
Complete Care at Sheridan CommonsChicago, IL, CCN 145776 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 29, 2021
Jun 29, 2021
Westwood Village Nursing and RehabChicago, IL, CCN 146149 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2023
May 1, 2023
La Bella of EdwardsvilleEdwardsville, IL, CCN 145846 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2024
Nov 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1275699209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223093",
            "telephone_number": "773-252-4848",
            "fax_number": "773-252-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "STE 320",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-342-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZIANO",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36091770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.