Michael J Di Domenico, PSYD is a medicare enrolled "Clinical Neuropsychologist" provider in Northbrook, Illinois. His current practice location is
707 Skokie Blvd Ste 600, Northbrook, Illinois. You can reach out to his office (for appointments etc.) via phone at
(630) 632-0746.
Michael J Di Domenico is licensed to practice in Illinois (license number 071005762) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1861442345.
Healthcare Provider's Profile
| Full Name | Michael J Di Domenico |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 707 Skokie Blvd Ste 600, Northbrook, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Michael J Di Domenico attended and graduated from in
NPI Data:
- NPI Number: 1861442345
- Provider Enumeration Date: 05/12/2006
- Last Update Date: 07/25/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Michael J Di Domenico such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861442345 | NPI | - | NPPES |
| 1623280 | Other | IL | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 071055762 (Illinois) | Secondary |
| 103TC0700X | Psychologist - Clinical | 071005762 (Illinois) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 071005762 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael J Di Domenico is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Michael J Di Domenico, PSYD
Po Box 472,
Northbrook, IL 60065-0472
Ph: (847) 504-4060 | Michael J Di Domenico, PSYD
707 Skokie Blvd Ste 600,
Northbrook, IL 60062-2841
Ph: (630) 632-0746 |
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