RAFAEL ROBERTO DOMINGUEZ M.D.
NPI 1104840073
Pediatrics in Chicago, IL

Q: What is Rafael Dominguez's NPI number?

The NPI number for Rafael Dominguez is 1104840073. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Q: What is Rafael Dominguez's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Rafael Dominguez was last updated on August 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 26, 2006PECOS Enrolled

1701 W SUPERIOR ST, CHICAGO, IL 60622(312) 666-3494 Get Directions Write a Review

NPPES record last updated: August 11, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Rafael Roberto Dominguez M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAFAEL ROBERTO DOMINGUEZ M.D. (NPI 1104840073) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (036112018) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104840073

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameRAFAEL ROBERTO DOMINGUEZCredential: M.D.

Location Address1701 W SUPERIOR STChicago, IL 60622-5646

Mailing Address1321 W Hood Ave # 2Chicago, IL 60660-2507 · (773) 856-5308

Phone(312) 666-3494

Sole ProprietorNo

Enumeration DateJuly 26, 2006

Last NPPES UpdateAugust 11, 2021

NPPES CertifiedAugust 11, 2021

✔ NPI 1104840073 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in IL · 036112018✔ Licensed in IL · 036-112018

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1701 W SUPERIOR ST, Chicago, IL 60622

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rafael Roberto Dominguez M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60622 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CAROLINE J TETER PA-C

Physician Assistant (Medical)