Individual
RAFAEL ROBERTO DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 W SUPERIOR ST, CHICAGO, IL 60622-5646
(312) 666-3494
Mailing address
1321 W HOOD AVE # 2, CHICAGO, IL 60660-2507
(773) 856-5308
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036-112018
IL
208000000X
Pediatrics Physician
Primary
036112018
IL
Other
Enumeration date
07/26/2006
Last updated
08/11/2021
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