Individual
DR. DOMINIC PHILIP CORSELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
109 E 23RD ST, HOUSTON, TX 77008-2513
(303) 521-8706
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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