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Mrs. Dominno Caroline Fogle, MMS,PA-C
Medical Physician Assistant in Deer Park, Illinois
NPI 1255615365

Dominno Caroline Fogle is a Medical Physician Assistant based in Carlock, IL and is specialized in Medical. Dominno Caroline Fogle practices in Deer Park, IL and has the professional credentials of MMS,PA-C. The NPI Number for Dominno Caroline Fogle is 1255615365 and holds a License No. 085004161 (Illinois).

The current practice location address for Dominno Caroline Fogle is 21660 W Field Pkwy, Deer Park, IL and can be reached out via phone at 888-803-3370.

Location: 21660 W Field Pkwy, Deer Park, IL, 61725-9020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255615365
Provider Name
Dominno Caroline Fogle
Credential
MMS,PA-C
Provider Entity Type
Individual
Gender
Female
Address
21660 W Field Pkwy, Deer Park, IL, 61725-9020
Phone Number
888-803-3370
Fax Number
Provider Enumeration Date
10/07/2011
Last Update Date
07/20/2024
institution
Provider Business Practice Location Address Details
Address
21660 W Field Pkwy
City
Deer Park
State
Illinois
Zip
60010-7265
Phone Number
888-803-3370
Fax Number
person
Provider Business Mailing Address Details
Address
21660 W Field Pkwy
City
Deer Park
State
Illinois
Zip
60010-7265
Phone Number
888-803-3370
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
085004161 (Illinois)
Definition
Definition to come...
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