Tara Elizabeth Doman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036121608 Issued in IL

Practice address

636 Raymond Dr
Suite 205
Naperville, IL 60563-9789

Phone

(630) 717-2300

Fax

(630) 717-9638

NPI assigned

Jun 11, 2007

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

Other identifiers 2

Other names 1

• Dr. Tara Elizabeth Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tdomanmd251713@direct.luriechildrens.org
• Direct secure messaging: taradoman@pha.allscriptsdirect.net

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.

• Ann & Robert H. Lurie Children'S Hospital of Chicago

  • Children's Hospital
  • Chicago, IL
  • NPI 1235234535
  NPD
• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  NPD (past)
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1407050826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 S Schmidt Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Bolingbrook",
            "state": "IL",
            "postal_code": "604403087",
            "country_code": "US",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24600 W 127th St Ste 135",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605859507",
            "country_code": "US",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 Miller Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "North Aurora",
            "state": "IL",
            "postal_code": "605421780",
            "country_code": "US",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "946 N Neltnor Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "West Chicago",
            "state": "IL",
            "postal_code": "601855989",
            "country_code": "US",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMAN",
        "first_name": "TARA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036121608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "2215474",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036121608",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "JACKSON",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Dockstader-Ortiz, PSY.D.
• Doctors Immediate Care
• Christopher Lee Doersam, D.C.
• Darcy A Doetch, M.A., CCC-SLP
• Kayla Dogadko, SLP
• Don Barry'S Counseling Service, Inc.
• Don C. Kalant Sr., D.D.S. and Assoc
• Tara Mae Donald, LCSW
• Lawrence Donaldson Jr.
• Jacilyn Doncoes, MOT

• Pediatrics Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.