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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. DOMONICQUE TATUM, EDD, LCSW

Active Sole Proprietor

DR. DOMONICQUE TATUM, EDD, LCSW is a Clinical Social Worker healthcare provider located in MARKHAM, Illinois. NPI 1629593173 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · MARKHAM, IL

Registration Details

NPI Number
1629593173
Provider Type
Individual
Gender
Male
NPI Issued
Aug 6, 2017 (8.997858655074 yrs)
Last Updated
Jul 21, 2022
License
149.017448 (IL)
Sole Proprietor
Yes

Practice Information

Address
16300 KEDZIE AVE
MARKHAM, IL, 604285508
Browse IL providers · Browse ZIP 60428
Phone
5712825193
Primary Specialty
Clinical Social Worker
1041C0700X

Other Clinical Social Worker Providers in MARKHAM, IL

Name Credential NPI
MS. HOPE GREEN MSW, LCSW 1508995804
NANCY RAMIREZ 1043166994
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.