OrganizationActive
M Dominguez Jr MD Sc
NPI 1609056795 · Primary Care Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1609056795
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Manuel Dominguez, President(773) 770-3409
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1431 N Western Ave
Suite 212
Chicago, IL 60622-1797
Phone: (773) 770-3409
Fax: (773) 770-3418
Street-level locationGet directions
Mailing address
1431 N Western Ave
Chicago, IL 60622-1797
Registry dates
- Enumerated
- 2007-11-06
- Last updated
- 2007-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.