JENNIFER PADERO DOMINGO – Nurse Practitioner, NPI 1790647782

JENNIFER PADERO DOMINGO is a healthcare provider. based in Chicago, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209.033597 (IL). The NPI Number for JENNIFER PADERO DOMINGO is 1790647782

Main info

Organization
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
JENNIFER PADERO DOMINGO
NPI
1790647782
Phone
Not provided
Address
1544 W CHICAGO AVE
Enumeration Date
27 November 2025
Last Update Date
27 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7734236400
Graduation Year
2025 (1 year ago)
PAC ID
9335627678
Group Practice PAC ID
6305028390
Professional Enrollment ID
I20260129000652
Address ID
IL606425236CH1540XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for JENNIFER PADERO DOMINGO

  • 1544 W CHICAGO AVE

    CHICAGO, IL 606425236

    Phone:

    Mailing address matches the actual address.

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: 2026-01-29

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
I20260129000652INurse PractitionerILTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60642)

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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: 6305028390View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nephrology, Internal MedicineIL
Physician AssistantIL
Nurse PractitionerIL
Nurse PractitionerIL
Registered Dietitian Or Nutrition ProfessionalIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

How is JENNIFER PADERO DOMINGO identified in CMS data?
CMS-hosted NPPES data lists JENNIFER PADERO DOMINGO with NPI 1790647782.
Does the file indicate JENNIFER PADERO DOMINGO is practicing under active NPI?
Directory data currently reports JENNIFER PADERO DOMINGO as active.
What healthcare role does JENNIFER PADERO DOMINGO hold?
Scheduling teams often label JENNIFER PADERO DOMINGO under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect JENNIFER PADERO DOMINGO on a map?
Expect Chicago, Illinois as a primary anchor for JENNIFER PADERO DOMINGO unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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