Individual provider Active NPI

Dominika Ventucci, LCSW

  • Clinical Social Worker
  • North Aurora, IL
National Provider Identifier
1558865741
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019733 Issued in IL
Practice address
703 Lloyd LN
North Aurora, IL 60542-9088
Phone
(773) 816-9804
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.019733 IL Primary

Addresses

Primary practice location

703 Lloyd LN
North Aurora, IL 60542-9088

Mailing address

703 Lloyd LN
North Aurora, IL 60542-9088
Phone (773) 816-9804

Other names 1

  • Dominika Bielinska Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180425002490 IL Practitioner - Clinical Social Worker 9234493354 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - IllinoisGroup PAC ID 6800263823, 45 clinicians

Practice addresses (Care Compare)

314 Susan Dr
Suite B
Normal, IL 61761-6206
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.019733ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Between Heartbeats LLC CurrentSince Nov 15, 2020 Accepting new patients
Thriveworks Clinical - Illinois CurrentSince Dec 4, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Oct 10, 2023 Accepting new patients
Blue Moon Senior Counseling of Illinois LLC Clinical CurrentSince Apr 20, 2021 Accepting new patients

Locations

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

333 N Michigan Ave
Ste 1810
Chicago, IL 60601
Phone (217) 850-1133

314 Susan Dr
#B
Normal, IL 61761

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1558865741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 LLOYD LN",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605429088",
            "telephone_number": "773-816-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 LLOYD LN",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605429088",
            "telephone_number": "773-816-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTUCCI",
        "first_name": "DOMINIKA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIKA",
            "last_name": "BIELINSKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Aurora, IL

Sources for this page

Verify at the official NPI Registry.