MEDICARE: CATHY DOMINGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	178.022485	IL

General Provider Information

NPI Number	:	1811841273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY DOMINGUEZ

Provider Business Mailing Address
First Line	:	1550 S INDIANA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-2857
Country	:	US
Telephone Number	:	773-377-5577
Fax Number	:

Provider Business Practice Location Address
First Line	:	2653 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1607
Country	:	US
Telephone Number	:	866-434-1735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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Directions to “ CATHY DOMINGUEZ ” Practice Location

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