Individual
HAZEL DHATES ASUNIO DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
259 E ERIE ST FL 16, CHICAGO, IL 60611-2987
(312) 695-5620
(312) 695-0042
Mailing address
676 N SAINT CLAIR ST STE 2000, CHICAGO, IL 60611-3147
(312) 695-4837
(312) 695-0042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.0007019
IL
363A00000X
Physician Assistant
—
MD
Other
Enumeration date
04/17/2015
Last updated
08/05/2019
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