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

Dr. Kathleen Marie Dominguez, MD

Individual provider Pediatric Surgery Physician · NPI 1285764886

Dr. Kathleen Marie Dominguez, MD is a Pediatric Surgery Physician in Urbana, Illinois. Licensed in Illinois and Wisconsin. Registered with an NPI since 2007.

Licensed in
IL, WI
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

611 W Park St
Urbana, IL 61801-2529
Phone: (217) 383-3100
Fax: (217) 383-4468
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Surgery Physician (primary) Taxonomy 2086S0120X · Licence 036146280 (IL)
Pediatric Surgery Physician Taxonomy 2086S0120X · Licence 57264 (WI)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence 036146280 (IL)
Surgery Physician Taxonomy 208600000X · Licence 036146280 (IL)

Record details

NPI number1285764886
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 6, 2007
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

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