Individual
DR. ERIN BETH DOMINIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1610 LUTHER LN, PARK RIDGE, IL 60068-1243
(847) 318-2303
Mailing address
1610 LUTHER LN, AMG - ADULT DOWN SYNDROME CENTER, PARK RIDGE, IL 60068-1243
(847) 318-2303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-118378
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-118378
PHYSICIAN LICENSE
IL
Enumeration date
06/21/2007
Last updated
12/17/2021
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