Dominno C. Fogle, M.M.S., PA-C
Physician Assistant · Deer Park, IL
UnclaimedM.M.S., PA-CNPI 1255615365
- Primary taxonomy
- 363AM0700X
- Enumerated
- 2011-10-07
- Practice location
- Deer Park, IL
- Last NPPES update
- 2024-06-10
State licenses
- IL · Physician assistant · LICENSED PHYSICIAN ASSISTANTActivethrough 2028
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.