Active NPI
Alexandra Gloria Dominguez
- Behavior Technician
- Oak Lawn, IL
National Provider Identifier
1740069814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-300321
- Practice address
- 4615 W 103Rd St
Oak Lawn, IL 60453-4718 - Phone
- (331) 229-8839
- NPI assigned
- Sep 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-300321 | Primary |
Addresses
Primary practice location
4615 W 103Rd St
Oak Lawn, IL 60453-4718
Mailing address
4615 W 103Rd St
Oak Lawn, IL 60453-4718
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1740069814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4615 W 103RD ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604534718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 W 103RD ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604534718",
"telephone_number": "331-229-8839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "ALEXANDRA",
"middle_name": "GLORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-27",
"last_updated": "2023-09-27",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "RBT-23-300321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.