Individual provider Active NPI

Dominador L Dayon Jr., M. D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1609989912
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036052751 Issued in IL
Practice address
7906 S Crandon Ave
Suite #4
Chicago, IL 60617-1146
Phone
(773) 768-5182
Fax
(773) 978-5930
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036052751 IL Primary

Addresses

Primary practice location

7906 S Crandon Ave
Suite #4
Chicago, IL 60617-1146

Mailing address

7906 S Crandon Ave
Suite #4
Chicago, IL 60617-1146
Phone (773) 768-5182

Other identifiers 2

IdentifierTypeStateIssuer
036052751MedicaidIL
21606243OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Dominador L Dayon Jr. Professional name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036052751ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dominador L. Dayon Jr., M.D.S.C. Family Medicine PastSince Dec 3, 2007 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. Past Accepting new patients

Organizations & group practices 2

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1609989912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7906 S CRANDON AVE",
            "address_2": "SUITE #4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171146",
            "telephone_number": "773-768-5182",
            "fax_number": "773-978-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7906 S CRANDON AVE",
            "address_2": "SUITE #4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171146",
            "telephone_number": "773-768-5182",
            "fax_number": "773-978-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYON",
        "first_name": "DOMINADOR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036052751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052751",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21606243",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINADOR",
            "last_name": "DAYON",
            "middle_name": "L",
            "suffix": "JR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Feb 27, 2012; 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.