Dr. Domingo Juco De La Fuente , MD
Specialist • Northbrook, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Domingo De La Fuente has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Domingo De La Fuente, MD was a registered Specialist practicing in Northbrook, IL. Throughout an active medical career spanning 9 years, Dr. De La Fuente provided care at the practice location at 1671 MISSION HILLS RD until profile deactivation on 2019-08-12.
Practice Location & Contact Primary Location
1671 Mission Hills Rd
Unit 402
Northbrook, IL 600625735
Specialty Benchmarks & Practice Insights
Comparative analytics for Specialist in Northbrook, IL
Practicing in Northbrook, IL (1322 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on August 12, 2019
NPI status registered as active in NPPES database
Registered at 1671 MISSION HILLS RD, UNIT 402, NORTHBROOK, IL 600625735 (Tel: 8477363003)
Registered at 1671 MISSION HILLS RD, UNIT 402, NORTHBROOK, IL 600625735 (Tel: 8477363003)
Recorded as DOMINGO DE LA FUENTE, M.D.
Specialist (License #036.046875 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1671 Mission Hills Rd, Unit 402
Northbrook, IL 600625735
Phone: 8477363003
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