Costabile, Dominic
Costabile, Dominic is an individual health care provider with primary practice located at 1315 Macom Dr Suite 005, Naperville IL 60564-9358. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Costabile, Dominic can be contacted via phone (630) 904-5640.Contact Information
Primary practice address
1315 Macom Dr Suite 005
Naperville IL 60564-9358
Phone: (630) 904-5640
Fax: (630) 470-9298
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036071000 | Illinois |
Profile Details
| NPI number | 1629043195 |
|---|---|
| LBN Legal business name | Costabile, Dominic |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 20th, 2006 |
| Last updated | Jun 5th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629043195 | NPPES |
| Illinois | MEDICAID | 036071000 |
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