Body and Mind Medical

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036091770 Issued in IL

Legal business name

BODY AND MIND MEDICAL

Practice address

2222 W Division St
Suite 130
Chicago, IL 60622-2717

Phone

(773) 252-4848

Fax

(773) 252-8484

NPI assigned

Oct 27, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Dominic Gaziano, M.D.NPI 1275699209

Title

President

Phone

(773) 988-2220

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dominic Gaziano, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1275699209
  NPD (past) Authorized official

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1851843692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "SUITE 130",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-252-4848",
            "fax_number": "773-252-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "SUITE 130",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-252-4848",
            "fax_number": "773-252-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY AND MIND MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "GAZIANO",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-988-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164006794",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036091770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ulana Bodnar, MD
• Julia Bodnya
• Svetlana Bodnya, PTA
• Alison M Bodor, OTR/L
• Olivia Boduch, OTR/L
• Body Beyond Chiropractic and Wellness Center, LLC
• Body Peace Nutrition
• Body to Soul, LLC
• Body Wisdom Counseling PLLC
• Body Within You

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.