Dr Domonicque Tatum, EDD, LCSW is a 
Social Worker - Clinical based in Markham, Illinois. Dr Domonicque Tatum is licensed to practice in Illinois (license number 149.017448) and his current practice location is 
16300 Kedzie Ave, Markham, Illinois. He can be reached at his office (for appointments etc.) via phone at 
(571) 282-5193.
NPI number for Dr Domonicque Tatum is 1629593173 and his current mailing address is 16300 Kedzie Ave, Markham, Illinois. He 
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1629593173.
				
				
				
				
				
		 
		
		 
Healthcare Provider's Profile
		
			
			
			| Full Name | Dr Domonicque Tatum | 
|---|
| Gender | Male | 
|---|
| Speciality | Social Worker - Clinical | 
|---|
| Location | 16300 Kedzie Ave, Markham, Illinois | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1629593173
 - Provider Enumeration Date: 08/06/2017
 - Last Update Date: 07/21/2022
 			
			
			 
		 
		 
Medical Identifiers
		Medical identifiers for Dr Domonicque Tatum such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
		| 1629593173 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
		| 1041C0700X | Social Worker - Clinical  | 149.017448 (Illinois) | Primary | 
		
		
			
			
			
		
		
		 
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Domonicque Tatum is 
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
		
		
 
Mailing Address and Practice Location
		
		| Mailing Address | Practice Location Address | 
		Dr Domonicque Tatum, EDD, LCSW 16300 Kedzie Ave, Markham, IL 60428-5508 Ph: (571) 282-5193 | Dr Domonicque Tatum, EDD, LCSW 16300 Kedzie Ave, Markham, IL 60428-5508 Ph: (571) 282-5193 | 
		
		 
Reviews and Comments