MICHAEL J DI DOMENICO PSYD NPI 1861442345

NPI Information

  • NPI: 1861442345
  • Provider Name: MICHAEL J DI DOMENICO, PSYD
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • Address: 707 SKOKIE BLVD STE 600
    NORTHBROOK, IL
    ZIP 60062
  • Phone: (630) 632-0746

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NPI Details

Michael J Di Domenico, PSYD is a clinical neuropsychologist in Northbrook, IL. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Michael J Di Domenico, PSYD NPI is 1861442345. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

707 SKOKIE BLVD STE 600
NORTHBROOK, IL
ZIP 60062-841
Phone: (630) 632-0746
Fax: (847) 272-8221

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychotherapy, 1 hour (HCPCS:90837)
  • Evaluation of neuropsychological test, each additional hour (HCPCS:96133)
  • Administration of psychological or neuropsychological test, each additional 30 minutes (HCPCS:96137)
  • Administration of psychological or neuropsychological test, first 30 minutes (HCPCS:96136)
  • Evaluation of neuropsychological test, first hour (HCPCS:96132)

The enumeration date for this NPI number is 5/12/2006 and was last updated on 7/25/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical071055762ILLINOISNo
2103TC0700XPsychologistClinical071005762ILLINOISNo
3103G00000XClinical Neuropsychologist071005762ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11623280OTHERILLINOISBLUE CROSS BLUE SHIELD

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: 3/30/2025

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