Individual
MRS. DOMINIQUE CLAIBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HOLIDAY PLAZA DR STE 170, MATTESON, IL 60443-2236
(708) 248-6305
Mailing address
600 HOLIDAY PLAZA DR STE 170, MATTESON, IL 60443-2236
(708) 248-6305
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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