Pamela Doloszycki, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209-003010 Issued in IL

Practice address

1001 Main St
Suite 200
Peoria, IL 61606-1907

Phone

(309) 672-5682

Fax

(309) 672-3147

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1861563397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061907",
            "telephone_number": "309-672-5682",
            "fax_number": "309-672-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061907",
            "telephone_number": "309-672-5682",
            "fax_number": "309-672-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLOSZYCKI",
        "first_name": "PAMELA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209-003010",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209003010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209003010",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN",
            "identifier": "209-003010",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Doherty
• Dolan Central Illinois Compounding LLC
• Dolan Central Illinois Compounding Pharmacy LLC
• Shannon Dolan
• Tonia Dolan
• Cassidy Louise Domagalla
• Matthew David Domico, MSW, LCSW
• Sarah E Dominique, APN CDE
• Jerome Taymon Domzalski, MD
• Janine E. Donahue, M.D.

• Pediatric Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.