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MRS. DOMINNO CAROLINE FOGLE M.M.S., PA-C
NPI 1255615365
Physician Assistant - Medical in Deer Park, IL

Active since October 07, 2011PECOS Enrolled
21660 W FIELD PKWY, DEER PARK, IL 60010(888) 803-3370 Get Directions Write a Review

NPPES record last updated: June 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Dominno Caroline Fogle M.m.s., Pa-c NPPES

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

MRS. DOMINNO CAROLINE FOGLE M.M.S., PA-C (NPI 1255615365) is an individual medical provider in Deer Park, Illinois, licensed in Illinois (085004161) and active in the NPI registry since October 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255615365
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. DOMINNO CAROLINE FOGLECredential: M.M.S., PA-C
Location Address21660 W FIELD PKWYDeer Park, IL 60010-7265
Mailing Address271 County Road 2325 ECarlock, IL 61725-9020 · (815) 931-0244
Phone(888) 803-3370
Sole ProprietorNo
Enumeration DateOctober 7, 2011
Last NPPES UpdateJune 10, 2024
NPPES CertifiedJune 10, 2024
✔ NPI 1255615365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085004161
21660 W FIELD PKWY, Deer Park, IL 60010
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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)

Mrs. Dominno Caroline Fogle M.m.s., Pa-c 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$215.80 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 13

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

TYLER HUANG
Student in an Organized Health Care Education/Training Program
21660 W FIELD PKWY
DEER PARK, IL 60010
Cook County (847) 692-9234
DR. MARTIN J ZIDRON D.D.S.
Dentist (Oral and Maxillofacial Pathology)
21660 W FIELD PKWY, SUITE 220
DEER PARK, IL 60010
Cook County (847) 381-0106
IRINA FRENKEL MSN, FNP-BC
Nurse Practitioner (Family)
21660 W FIELD PKWY
DEER PARK, IL 60010
Cook County (847) 338-0339
DANESHA HOWARD FNP-BC
Nurse Practitioner (Family)
21660 W FIELD PKWY
DEER PARK, IL 60010
Cook County (630) 949-7369
SERAPHIC FAMILY CARE AND WELLNESS LLC
Clinic/Center (Primary Care)
21660 W FIELD PKWY
DEER PARK, IL 60010
Cook County (847) 900-8796
DR. JOHN TRAVIS THOMPSON D.D.S.
Dentist (Oral and Maxillofacial Surgery)
21660 W FIELD PKWY, SUITE 220
DEER PARK, IL 60010
Cook County (847) 381-0106
NIKKI BORAH TANG PA-C
Physician Assistant
21660 W FIELD PKWY
DEER PARK, IL 60010
Cook County (888) 803-3370
FAHEEM UNISA SYED APNP
Nurse Practitioner (Family)
21660 W FIELD PKWY
DEER PARK, IL 60010
Cook County (415) 840-0560

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominno Fogle's NPI number?

The NPI number for Dominno Fogle is 1255615365. It was assigned to this individual provider in the NPPES registry on October 7, 2011.

Where is Dominno Fogle located?

Dominno Fogle practices at 21660 W Field Pkwy, Deer Park, IL 60010. The listed phone number is (888) 803-3370.

What is Dominno Fogle's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Dominno Fogle enrolled in Medicare?

Yes. Dominno Fogle is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dominno Fogle was last updated on June 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.