Individual
DR. JASON GLENN DOMINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 334-5566
(815) 759-4008
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 334-5566
(815) 759-4008
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036159775
IL
2085R0202X
Diagnostic Radiology Physician
4301094862
MI
Other
Enumeration date
07/12/2009
Last updated
11/09/2023
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