Costabile, Dominic

Costabile, Dominic is an individual health care provider with primary practice located at 1315 Macom Dr Suite 005, Naperville IL 60564-9358. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Costabile, Dominic can be contacted via phone (630) 904-5640.

Contact Information

Primary practice address
1315 Macom Dr Suite 005 Naperville IL 60564-9358
Phone: (630) 904-5640
Fax: (630) 470-9298
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036071000 Illinois

Profile Details

NPI number 1629043195
LBN Legal business name Costabile, Dominic
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Jun 5th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629043195 NPPES
Illinois MEDICAID 036071000

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