Individual
LAURA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.C.P.T.
Contact information
Practice address
400 LILLIAN LN, DES PLAINES, IL 60016-2518
(224) 242-9630
(215) 215-8838
Mailing address
400 LILLIAN LN, DES PLAINES, IL 60016-2518
(773) 817-0477
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
851198
IL
Other
Enumeration date
09/12/2020
Last updated
09/12/2020
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