Imburgia, Dominic Charles

Imburgia, Dominic Charles is an individual health care provider with primary practice located at 901 N Maple St , Effingham IL 62401-6401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Imburgia, Dominic Charles can be contacted via phone (217) 347-2900.

Contact Information

Primary practice address
901 N Maple St Effingham IL 62401-6401
Phone: (217) 347-2900
Fax: (217) 347-2922
Website:
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Health care specialties

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

Profile Details

NPI number 1114955960
LBN Legal business name Imburgia, Dominic Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jul 8th, 2007 - about 19 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 1114955960 NPPES
Illinois Other 238531 HEALTHLINK
Illinois Other 40058 HEALTHLINK
Illinois MEDICAID 03664959 HEALTHLINK
Illinois Other 03800063 HEALTHLINK

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