# CHICAGO REGENERATIVE MEDICAL CENTER CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275186033
- **Authorized official:** DR. VINCENT DOMINGO DC (CEO)
- **Authorized official phone:** (773) 562-2632

## Contact information

- **Practice address:** 4149 W 26TH ST, CHICAGO, IL 60623-4314
- **Practice address phone:** (877) 542-1110
- **Mailing address:** 4149 W 26TH ST, CHICAGO, IL 60623-4314
- **Mailing address phone:** (773) 562-2632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/22/2019
- **Last updated:** 05/26/2020