Dominguez, Kathleen Marie

Dominguez, Kathleen Marie is an individual health care provider with primary practice located at 611 W Park St , Urbana IL 61801-2529. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as her primary health care specialty. Dominguez, Kathleen Marie can be contacted via phone (217) 383-3100.

Contact Information

Primary practice address
611 W Park St Urbana IL 61801-2529
Phone: (217) 383-3100
Fax: (217) 383-4468
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 57264 Wisconsin
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 036146280 Illinois

Profile Details

NPI number 1285764886
LBN Legal business name Dominguez, Kathleen Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Jul 30th, 2019 - about 6 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.

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