Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominique V Azarcon, PA-C

Individual provider Physician Assistant · NPI 1780918920

Dominique V Azarcon, PA-C is a Physician Assistant in Park Ridge, Illinois. Qualified in 2009, 17 years ago. Practices with Vivek Gupta, MD, SC, a 28-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
17
Licensed in
IL
In the registry since
2009
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1420 Renaissance Dr Ste 207
Park Ridge, IL 60068-1330
Phone: (847) 296-6161
Fax: (847) 296-6262
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 800 Biesterfield Rd Ste 610, Elk Grove Village, IL 60007-3362 — (847) 981-3630

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-003546 (IL)

Record details

NPI number1780918920
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 21, 2009
Last updated in NPPESApril 6, 2021
Certification dateApril 6, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Vivek Gupta, M.D., S.C. — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Park Ridge