Individual
MRS. DOMINIQUE KOSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
710 N FAIRBANKS CT, CHICAGO, IL 60611-3013
(312) 472-0038
Mailing address
710 N FAIRBANKS CT, CHICAGO, IL 60611-3013
(312) 472-0038
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005602
IL
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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