Individual
CARMINA AMOR TAN DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4205 WESTBROOK DR, AURORA, IL 60504-4124
(630) 961-4150
(630) 961-4151
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0102203419
VA
2084N0400X
Neurology Physician
Primary
036-159001
IL
Other
Enumeration date
06/28/2011
Last updated
08/07/2023
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