Rafael Roberto Dominguez, MD in Chicago, IL

Rafael Roberto Dominguez, MD is a medicare enrolled "Pediatrics" physician in Chicago, Illinois. His current practice location is 1701 W Superior St, Chicago, Illinois. You can reach out to his office (for appointments etc.) via phone at (312) 666-3494.

Rafael Roberto Dominguez is licensed to practice in Illinois (license number 036112018) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104840073.

Contact Information

	Rafael Roberto Dominguez, MD
	1701 W Superior St, Chicago, IL 60622-5646
	(312) 666-3494
	Not Available

Map and Direction

Physician's Profile

Full Name	Rafael Roberto Dominguez
Gender	Male
Speciality	Pediatrics
Location	1701 W Superior St, Chicago, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104840073
Provider Enumeration Date: 07/26/2006
Last Update Date: 08/11/2021

Medicare PECOS Information:

PECOS PAC ID: 1658315478
Enrollment ID: I20050613001238

Medical Identifiers

Medical identifiers for Rafael Roberto Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104840073	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	036-112018 (Illinois)	Secondary
208000000X	Pediatrics	036112018 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Rafael Roberto Dominguez allows following entities to bill medicare on his behalf.

Entity Name	Erie Family Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760499545 PECOS PAC ID: 9537050422 Enrollment ID: O20040322000689

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. Rafael Roberto Dominguez 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
Rafael Roberto Dominguez, MD 1321 W Hood Ave # 2, Chicago, IL 60660-2507 Ph: (773) 856-5308	Rafael Roberto Dominguez, MD 1701 W Superior St, Chicago, IL 60622-5646 Ph: (312) 666-3494

Reviews and Comments

Pediatrics Doctors in Chicago, IL

Nupur Mittal, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1725 W. Harrison St Suite 710, Rush University Medical Center,, Chicago, IL 60612 Phone: 312-942-5983 Fax: 312-563-2519
Dr. Gustave Falciglia, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave # 45, Chicago, IL 60611 Phone: 312-227-4190
Bessey Elizabeth Jose Geevarghese, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 225 E Chicago Ave, Chicago, IL 60611 Phone: 630-933-6631
Bernadeta Leegan Wibisono, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2951 S King Dr Apt 1004, Chicago, IL 60616 Phone: 312-351-1346
Kyle L Macquarrie, MD PHD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave # 30, Chicago, IL 60611 Phone: 312-227-4000
Amy Pham, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1740 W Taylor St, Chicago, IL 60612 Phone: 866-600-2273
Anne Smazal, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave, Chicago, IL 60611 Phone: 563-340-8186

Rafael Roberto Dominguez, MD - Medicare Pediatrics in Chicago, IL