M DOMINGUEZ JR MD SC

NPI # 

Practice Address:

1431 N Western Ave , Suite 212

Chicago, IL, 60622-1797

Practice Phone:

773-770-3409

Practice Fax:

773-770-3418

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Primary Care

Taxonomy Code:

261QP2300X

Updated by NPPES on 11/6/2007. You can view the original data set for NPI # 1609056795 on the official NPPES website. If the information about this NPI provider/company is outdated you can request updates through the NPPES website. See our FAQ page for more information.

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