DR. KATHLEEN MARIE DOMINGUEZ M.D.
NPI 1285764886
Surgery - Pediatric Surgery in Urbana, IL

Q: What is Kathleen Dominguez's NPI number?

The NPI number for Kathleen Dominguez is 1285764886. It was assigned to this individual provider in the NPPES registry on March 6, 2007. The provider is also known as Ms. Kathleen Marie Cavanagh.

Q: What is Kathleen Dominguez's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Active since March 06, 2007PECOS Enrolled

611 W PARK ST, URBANA, IL 61801(217) 383-3100(217) 383-4468 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Kathleen Marie Dominguez M.d. NPPES

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

DR. KATHLEEN MARIE DOMINGUEZ M.D. (NPI 1285764886) is an individual pediatric surgery provider in Urbana, Illinois, licensed in Illinois (036146280) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285764886

Entity TypeIndividualFemale

Primary Taxonomy2086S0120X

Provider Legal NameDR. KATHLEEN MARIE DOMINGUEZCredential: M.D.

Location Address611 W PARK STUrbana, IL 61801-2529

Mailing Address611 W Park StUrbana, IL 61801-2501

Phone(217) 383-3100

Fax(217) 383-4468

Sole ProprietorNo

Enumeration DateMarch 6, 2007

Last NPPES UpdateOctober 21, 2025

NPPES CertifiedOctober 21, 2025

✔ NPI 1285764886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0120X

Licenses✔ Licensed in IL · 036146280✔ Licensed in WI · 57264

Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

Also ListedSurgeryTaxonomy 208600000X · License 036146280 (IL)

Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X · License 036146280 (IL)

611 W PARK ST, Urbana, IL 61801

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Other Names 1

Former Name (1)Ms. Kathleen Marie Cavanagh

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kathleen Marie 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.

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.

DR. UDAY BHASKAR KANAKADANDI MD

Internal Medicine (Interventional Cardiology)

611 W PARK ST, HVI
URBANA, IL 61801

Champaign County (217) 383-3110

DR. VIKAS DESAI MD

Urology