Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jerome Taymon Domzalski, MD

Individual provider Diagnostic Radiology Physician · NPI 1952539280

Dr. Jerome Taymon Domzalski, MD is a Diagnostic Radiology in Peoria, Illinois. Graduated from Duke University School of Medicine in 2009, 17 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho, Illinois, Oregon and Washington.

Years since qualifying
17
Trained at
Duke University School of Medicine
Licensed in
ID, IL, OR, WA
In the registry since
2009
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-4748
Phone: (309) 655-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 — (425) 563-1500

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 036-164444 (IL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence MD185931 (OR)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence MD60808674 (WA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence M-14669 (ID)

Record details

NPI number1952539280
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 25, 2009
Last updated in NPPESOctober 23, 2023
Certification dateOctober 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolDUKE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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