SearchIllinois171M00000X

Dominique Bolden

NPI 1306617345 · on the registry since 2024 · sole proprietor

Practice

Address
4811 S Wabash Ave Apt 2
Chicago, IL 60615
Phone
(708) 776-3548

Registry record

Primary taxonomy
171M00000X
171M00000X
Sex
Male
Record last updated
2024-01-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois