Search › Illinois › 376K00000X
Dominique Tatum
NPI 1396410726 · on the registry since 2021
Practice
- Address
- 2644 Conklin Dr Apt 1
Rockford, IL 61101 - Phone
- (815) 713-5685
Registry record
- Primary taxonomy
- 376K00000X
376K00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-08-09
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