Organization
ZIGMA VISITING PHYSICIAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVILLO M DOMINGO M.D. (PRESIDENT)
(567) 224-6045
Entity
Organization
Contact information
Practice address
4 N DEER POINT DR, 1002, HAINESVILLE, IL 60030
(847) 946-0198
(847) 972-6265
Mailing address
4 N DEER POINT DR, 1002, HAINESVILLE, IL 60030-3814
(847) 946-0198
(847) 972-6265
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/07/2016
Last updated
09/26/2019
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