Organization
VINCENT DOMINGO DC SC
Active
Other names
Performance Health Medical & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT DOMINGO DC (CHIROPRACTIC PHYSICIAN)
(847) 671-0555
Entity
Organization
Contact information
Practice address
3545 N ROSE STREET, FRANKLIN PARK, IL 60131
(847) 671-0555
(847) 671-0685
Mailing address
3545 N ROSE STREET, FRANKLIN PARK, IL 60131
(847) 671-0555
(847) 671-0685
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
225400000X
Rehabilitation Practitioner
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635354
BCBS
IL
01
—
K19177
MEMBER
—
Enumeration date
01/17/2008
Last updated
01/06/2014
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