Individual
DR. HENRY A. DOMINICIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1051 W RAND RD, SUITE 101, ARLINGTON HEIGHTS, IL 60004-2315
(847) 221-4900
(847) 221-4996
Mailing address
363 W NORTHWEST HWY, CENTURY PLAZA, PALATINE, IL 60067-2414
(847) 221-4601
(847) 221-4691
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-078296
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
748450
MEDICARE GROUP PROVIDER
IL
Enumeration date
10/20/2005
Last updated
04/03/2013
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