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

Individual provider Clinical Social Worker · NPI 1629593173

Dr. Domonicque Tatum, EDD, LCSW is a Clinical Social Worker in Markham, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2017
What do these letters mean?
EDD — Doctor of Education
A doctorate in education.
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

16300 Kedzie Ave
Markham, IL 60428-5508
Phone: (571) 282-5193
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149.017448 (IL)

Record details

NPI number1629593173
Entity typeIndividual (Type 1)
GenderMale
Credentials EDD , LCSW
Sole proprietorYes
NPI enumeratedAugust 6, 2017
Last updated in NPPESJuly 21, 2022

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