Individual provider · Type 1 NPI
Dominno Caroline Fogle, M.M.S., PA-C
Medical Physician Assistant · Deer Park, IL
NPI number
1255615365
Active
Practice location
21660 W Field Pkwy
Deer Park, IL 60010-7265
Mailing address
271 County Road 2325 E
Carlock, IL 61725-9020
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 085004161 (IL) |
Medical Physician Assistant: Definition to come...
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- Seraphic Family Care and Wellness LLCPrimary Care Clinic/Center Deer Park, IL NPI 1548155765
- Ankita Dalal, MDFamily Medicine Physician Deer Park, IL NPI 1619311644
- Danesha Howard, FNP-BCFamily Nurse Practitioner Deer Park, IL NPI 1255760799
- Faheem Unisa Syed, APNPFamily Nurse Practitioner Deer Park, IL NPI 1649719618
- Irina Frenkel, MSN, FNP-BCFamily Nurse Practitioner Deer Park, IL NPI 1194114223
- John Travis Thompson, DDSOral and Maxillofacial Surgery (Dentist) Deer Park, IL NPI 1558324459
- Kelsey L. Proehl, FNP-BCFamily Nurse Practitioner Deer Park, IL NPI 1699315697
- Martin J. Zidron, DDSOral and Maxillofacial Pathology Dentistry Deer Park, IL NPI 1164462362
About NPI 1255615365
Dominno Caroline Fogle, M.M.S., PA-C's National Provider Identifier is 1255615365, issued on Oct 7, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Deer Park, IL. The record was last updated on Jun 10, 2024.