Individual
DR. JOHN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
500 DAVIS ST STE 815, EVANSTON, IL 60201-4655
(312) 640-7740
Mailing address
500 DAVIS ST STE 815, EVANSTON, IL 60201-4655
(312) 640-7740
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006465
IL
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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