SearchIllinois207Q00000X

Ma Portia Bernadette Domingo, DO

NPI 1700573722 · on the registry since 2023

Practice

Address
1701 E College Ave
Bloomington, IL 61704
Phone
(309) 664-3000
Organisation at this address
St Joseph Medical Center
St. Joseph Medical Center
Carle Foundation Hospital
Carle Foundation Hospital
Osf Multi-Specialty Group
Inferred from a shared address, not stated in the registry.
Clinicians at this address
61

Additional practice sites

  • 819 S 13th St, Mount Vernon, WA

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Also registered as
204D00000X
390200000X
Licence states on file
IL, WA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-09-03

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