Organization · Type 2 NPI

M Dominguez JR MD SC

Primary Care Clinic/Center · Chicago, IL

NPI number 1609056795 Active

Practice location

1431 N Western Ave, Suite 212
Chicago, IL 60622-1797

Call (773) 770-3409 Map

Fax (773) 770-3418

Specialties and licenses

TaxonomyCodeLicense
Primary Care Clinic/Center Primary 261QP2300XNone listed

Primary Care Clinic/Center: Definition to come...

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About NPI 1609056795

M Dominguez JR MD SC's National Provider Identifier is 1609056795, issued on Nov 6, 2007. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Chicago, IL. The record was last updated on Nov 6, 2007.