Individual
DR. DOMINIC EDWARD FULLENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 E HURON ST, GALTER 3-150, CHICAGO, IL 60611-2908
(312) 926-2000
Mailing address
251 E HURON ST, GALTER 3-150, CHICAGO, IL 60611-2908
(312) 926-2000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036141808
IL
Other
Enumeration date
03/28/2014
Last updated
01/14/2017
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