| Mrs Dominno Caroline Fogle, MMS, PA-C | |
|
21660 W Field Pkwy, Deer Park, IL 60010-7265 | |
| (888) 803-3370 | |
| Not Available |
| Full Name | Mrs Dominno Caroline Fogle |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 21660 W Field Pkwy, Deer Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255615365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 085004161 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Dominno Caroline Fogle, MMS, PA-C 271 County Road 2325 E, Carlock, IL 61725-9020 Ph: (815) 931-0244 | Mrs Dominno Caroline Fogle, MMS, PA-C 21660 W Field Pkwy, Deer Park, IL 60010-7265 Ph: (888) 803-3370 |
Gabriella Tenuta, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 21625 W Field Ct, Deer Park, IL 60010 Phone: 847-337-4258 | |
Nikki Borah Tang, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 21660 W Field Pkwy, Deer Park, IL 60010 Phone: 888-803-3370 |