Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

M Dominguez Jr MD SC

Organization Primary Care Clinic/Center · NPI 1609056795

M Dominguez Jr MD SC is a Primary Care Clinic/Center in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007

Practice location Address checks out

1431 N Western Ave Ste 212
Chicago, IL 60622-1797
Phone: (773) 770-3409
Fax: (773) 770-3418
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X (IL)

Record details

NPI number1609056795
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Manuel Dominguez — President · (773) 770-3409
NPI enumeratedNovember 6, 2007
Last updated in NPPESNovember 6, 2007
Mailing address1431 N Western Ave, Suite 212, Chicago, IL 60622-1797

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