M DOMINGUEZ JR MD SC


Address: 1431 N Western Ave, Suite 212, Chicago, IL 60622-1797
Phone: 7737703409

M DOMINGUEZ JR MD SC (NPI# 1609056795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609056795
Entity Type Organization
Organization Name M DOMINGUEZ JR MD SC
Practice Address 1431 N Western Ave
Suite 212
Chicago
IL 60622-1797
Practice Telephone 7737703409
Practice Fax Number 7737703418
Mailing Telephone 7737703409
Mailing Fax Number 7737703418
Enumeration Date 2007-11-06
Last Update Date 2007-11-06
Authorized Official Name DR. MANUEL GARCIA DOMINGUEZ JR. (PRESIDENT)
Authorized Official Telephone 7737703409
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
IL Ambulatory Health Care Facilities

Office Location

Street Address 1431 N WESTERN AVE
SUITE 212
City CHICAGO
State IL
Zip Code 60622-1797

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023017480 Ada I Arias Md Sc Internal Medicine 1431 N Western Ave, Ste 133, Chicago, IL 60622-1797 2005-07-19
1609302900 Clemen Gonzalez Student in an Organized Health Care Education/Training Program 1431 N Western Ave, Suite 406, Chicago, IL 60622-1797 2017-05-05
1205374964 Primecare Community Health Inc Clinic/Center 1431 N Western Ave, Suite 401, Chicago, IL 60622-1797 2017-02-02
1336692359 Primecare Community Health Inc. Clinic/Center 1431 N Western Ave, Suite 209, Chicago, IL 60622-1797 2016-07-26
1760835250 Teresa Zasowski Student in an Organized Health Care Education/Training Program 1431 N Western Ave, Suite 406, Chicago, IL 60622-1797 2016-07-19
1376994723 Angie Aybar Family Medicine 1431 N Western Ave, Suite 406, Chicago, IL 60622-1797 2016-06-28
1598111924 Roger Alvarez Soto Student in an Organized Health Care Education/Training Program 1431 N Western Ave, Suite 406, Chicago, IL 60622-1797 2016-05-04
1558722074 Andrea Kuebbeler Social Worker 1431 N Western Ave, Suite 406, Chicago, IL 60622-1797 2016-03-10
1548640675 Iffath Hussain Student in an Organized Health Care Education/Training Program 1431 N Western Ave, Suite 406, Chicago, IL 60622-1797 2015-06-03
1982083176 Patrick Porter Physical Therapist 1431 N Western Ave, Suite 510, Chicago, IL 60622-1797 2015-05-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1447880471 Erikson Institute Clinic/Center 2739 W Division St, Chicago, IL 60622 2020-01-17
1720620545 Emily Claire Bonanno Counselor 1397 N Miwaukee Ave, Chicago, IL 60622 2019-10-14
1891342093 Taylor Mallon Speech-Language Pathologist 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 2019-08-22
1083260277 Maggie Inman Student in an Organized Health Care Education/Training Program 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 2019-08-13
1174176168 Karol Maricel Quelal Analuisa Internal Medicine 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 2019-07-19
1073076105 Nichole Galullo Social Worker 1431 N Claremont 2nd Floor, Chicago, IL 60622 2019-04-06
1003375122 Alfredo Delgado Perez Sr. Psychologist 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 2019-03-18
1841773439 Abigail Hector Counselor 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 2018-09-11
1164916144 Dorothy Mitkowski Student in an Organized Health Care Education/Training Program 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 2018-06-21
1255825121 Kara Lynn Daniel Speech-Language Pathologist 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 2018-06-14
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1538792221 Greenbax Health Solutions, LLC Clinic/Center 4922 W Chicago Ave, Chicago, IL 60651-3142 2020-02-20
1033760780 Careatc Clinic/Center 600 S Michigan Ave # 402, Chicago, IL 60605-1900 2019-09-24
1356814503 Thompson Medical Incorporated Clinic/Center 933 E Hyde Park Blvd Ste G, Chicago, IL 60615-2722 2019-01-09
1497251037 Thomas L Pitts, Md LLC Clinic/Center 233 E Erie St Ste 702, Chicago, IL 60611-5933 2018-04-03
1407209208 Mount Sinai Hospital Medical Center Clinic/Center 1501 S California Ave # L1026, Chicago, IL 60608-1732 2016-07-16
1487058731 Encinas Medical Center Clinic/Center 4614 S Ashland Ave, Chicago, IL 60609-3251 2014-10-15
1366872061 Lawndale Christian Health Center Clinic/Center 5122 S Archer Ave, Chicago, IL 60632-4508 2013-11-15
1083051643 Oak Street Health Physicians Group, PC Clinic/Center 30 W Monroe St Ste 1200, Chicago, IL 60603-2420 2013-05-22
1043564529 Triple S Medical Care S.c. Clinic/Center 6455 S Pulaski Rd, Chicago, IL 60629 2012-11-05
1548541022 Valentinalb,s.c. Clinic/Center 5108 N Lincoln Ave, Chicago, IL 60625-7295 2011-08-29
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Competitor

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City CHICAGO
Zip Code 60622

Improve Information

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Dataset Information

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.

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