Organization
DOMINADOR L. DAYON JR., M.D.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINADOR L DAYON JR. M.D. (SOLE PROPRIETOR)
(708) 307-3555
Entity
Organization
Contact information
Practice address
7906 S CRANDON AVE, SUITE # 4, CHICAGO, IL 60617-1146
(773) 768-5182
(773) 978-5930
Mailing address
11145 MARILYN CT, ORLAND PARK, IL 60467-7467
(708) 307-3555
(773) 978-5930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036052751
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036052751
—
IL
01
—
21606243
BC/BS PROVIDER
IL
Enumeration date
09/12/2007
Last updated
11/16/2007
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