DR. EVILLO M DOMINGO (MD) – Family Medicine Physician, NPI 1770587693

DR. EVILLO M DOMINGO (MD) is a healthcare provider. based in Batavia, Illinois. specializing in GERIATRIC MEDICINE, FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 35-07-4369-D (OH). The NPI Number for DR. EVILLO M DOMINGO (MD) is 1770587693

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
DR. EVILLO M DOMINGO (MD)
NPI
1770587693
Phone
(567) 224-0854
Address
2405 BIG WOODS DR
Enumeration Date
9 June 2005
Last Update Date
10 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6302779651
Graduation Year
1981 (45 years ago)
PAC ID
7719962737
Group Practice PAC ID
7416489943
Professional Enrollment ID
I20160310000772
Address ID
IL605107650BA2405XDRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

244 GERIATRIC MEDICINE in IL

Provider Addresses for DR. EVILLO M DOMINGO (MD)

  • 2405 BIG WOODS DR

    BATAVIA, IL 605107650

    Phone: (567) 224-0854

    Type: Mailing

  • 2750, Neal Zick Road, New Haven, New Haven Township, Huron County, Ohio, 44890, United States

    WILLARD, OH 448909282

    Phone: (567) 224-0854

    Type: Mailing

  • 25, Spring Street, Marion, Plymouth County, Massachusetts, 02738, United States

    PLYMOUTH, OH 44865

    Phone: (419) 687-5781

    Fax: (419) 687-5018

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-03-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160310000772IFamily PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0179Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a4024$0
G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and2421$0
View full utilization report →

Insurance plans in this area (ZIP 60510)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416489943View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Can I cross-check DR. EVILLO M DOMINGO (MD) using NPI 1770587693?
NPI 1770587693 belongs to DR. EVILLO M DOMINGO (MD); compare other details if you need extra assurance.
Active or inactive — what applies to DR. EVILLO M DOMINGO (MD)?
You should see DR. EVILLO M DOMINGO (MD) as active in CMS-hosted NPPES data.
What area of care is associated with DR. EVILLO M DOMINGO (MD)?
DR. EVILLO M DOMINGO (MD)'s record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is DR. EVILLO M DOMINGO (MD) registered?
Use Batavia, Illinois as the headline location for DR. EVILLO M DOMINGO (MD) here.
When was this NPI issued?
Enumeration for DR. EVILLO M DOMINGO (MD) is noted as June 9, 2005 where the registry provides it.

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