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KATHRYN MARIE DOMINICK DO NPI 1437640901


NPI Information

NPI: 1437640901
Provider Name: KATHRYN MARIE DOMINICK, DO
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1170 FORTUNE BLVD
SHILOH, IL
ZIP 62269
Phone: (618) 997-5266
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Kathryn Marie Dominick, DO is an obstetrics gynecology in Shiloh, IL with 6 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Kathryn Marie Dominick, DO NPI is 1437640901. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year:2018

The provider's business location address is:

1170 FORTUNE BLVD
SHILOH, IL
ZIP 62269-358
Phone: (618) 997-5266
Fax: (618) 997-5285

The NPI 1437640901 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/21/2018 and was last updated on 3/2/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training Program5151011654MICHIGANNo
2207V00000XObstetrics & Gynecology036161559ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.