Rocco John Domanico, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071005136 Issued in IL

Practice address

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029

Phone

(847) 755-8090

Fax

(847) 843-7393

NPI assigned

Sep 8, 2006

Sex

Male

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 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rocco.domanico.1@380.direct.athenahealth.com

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.

• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1750485975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANICO",
        "first_name": "ROCCO",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1625854",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rocco.domanico.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1786 Moon Lake Blvd",
            "address_2": "Suite 104",
            "city": "Hoffman Estates",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601695029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eraj Din, M.D.
• Divine Smiles, PLLC
• Miroslav Djordjevic, CSA
• Damien Dodd, L.C.S.W.
• Dogan MD SC
• Vincent Donlon, ANP, NP
• Donna Luchetta
• Kelly Earline Donovan
• Alexandra Christine Taylor Downing, D.O.
• Elizabeth A. Doyle, LCPC

• Clinical Psychologist in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.