Healthcare Provider Details

I. General information

NPI: 1528983863
Provider Name (Legal Business Name): CLEARWAKE PLAINFIELD INTEGRATED HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16310 S LINCOLN HWY STE 128
PLAINFIELD IL
60586-9064
US

IV. Provider business mailing address

16310 S LINCOLN HWY STE 128
PLAINFIELD IL
60586-9064
US

V. Phone/Fax

Practice location:
  • Phone: 815-782-8440
  • Fax:
Mailing address:
  • Phone: 815-782-8440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: VINCENT DOMINGO
Title or Position: OWNER
Credential: DC
Phone: 815-782-8440