Individual provider · Type 1 NPI
Kathleen Marie Dominguez, MD
Pediatric Surgery Physician · Urbana, IL
NPI number
1285764886
Active
Practice location
611 W Park St
Urbana, IL 61801-2529
Fax (217) 383-4468
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 57264 (WI) |
| Pediatric Surgery Physician Primary | 2086S0120X | 036146280 (IL) |
| Surgical Critical Care Physician | 2086S0102X | 036146280 (IL) |
| Surgery Physician | 208600000X | 036146280 (IL) |
Pediatric Surgery Physician: A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
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About NPI 1285764886
Kathleen Marie Dominguez, MD's National Provider Identifier is 1285764886, issued on Mar 6, 2007. The primary taxonomy on file is Pediatric Surgery Physician (2086S0120X), and the practice location is in Urbana, IL. The record was last updated on Oct 21, 2025.