Individual
SARAH E DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN CDE
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-2480
Mailing address
1400 FLOSSMOOR AVE, WASHINGTON, IL 61571-1108
Taxonomy
Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
209010901
IL
Other
Enumeration date
12/31/2013
Last updated
12/21/2017
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