DR. DOMINGO JUCO DE LA FUENTE (NPI# 1033410485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033410485 |
| Entity Type | Individual |
| Full Name | DR. DOMINGO JUCO DE LA FUENTE |
| Credential | M.D. |
| Practice Address |
1671 Mission Hills Rd Unit 402 Northbrook IL 60062-5735 |
| Practice Telephone | 8477363003 |
| Practice Fax Number | 8472918237 |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2014-12-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036.046875 | IL | Other Service Providers |
| Street Address |
1671 MISSION HILLS RD UNIT 402 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-5735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902185242 | Eleanor Patricia Ruffin | Specialist | 1933 Redwood Ln, Northbrook, IL 60062-3626 | 2011-08-04 |
| 1073772679 | Jovanka Yvonne Hedeker | Specialist | 3000 Dundee Rd Suite 411, North Shore Wellness Services, Northbrook, IL 60062 | 2008-06-09 |
| 1669590667 | Serge G Tyler | Specialist | 2572 Joshua Ln, Northbrook, IL 60062-6963 | 2007-03-27 |
| 1710011598 | Young Byun | Specialist | 1775 Walters Ave, Northbrook, IL 60062-4591 | 2007-03-15 |
| 1184683765 | A Jerald Rothenberg | Specialist | 2270 Arbeleda Ln, Northbrook, IL 60062 | 2006-03-21 |
| 1528476694 | Jennifer Mandell | Specialist | 1535 Lake Cook Rd, 112, Northbrook, IL 60062-1447 | 2014-08-01 |
| 1235474222 | Martin Roy First | Specialist | 1 Astellas Way, Northbrook, IL 60062-6111 | 2012-12-03 |
| 1740540178 | Michael A. Epstein Md Sc | Specialist | 1535 Lake Cook Rd, Suite 211, Northbrook, IL 60062-1447 | 2012-05-18 |
| 1215268800 | The Nit Pickers | Specialist | 3000 Dundee Rd, Suite 409, Northbrook, IL 60062-2422 | 2010-01-20 |
| 1801074745 | Elissa Geier | Specialist | 1500 Skokie Blvd, Suite 203, Northbrook, IL 60062-4121 | 2008-02-02 |
| Find all providers in NORTHBROOK | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on DR. DOMINGO JUCO DE LA FUENTE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.