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1134391881
DOMINIQUE K FONS
URBANA, IL
NPI
1134391881
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036127508)
Enumeration Date
2008-04-01
Last Update Date
2014-09-23
Business Address
-- DOMINIQUE K FONS MD
611 W PARK ST
URBANA, IL 61801-2500
Phone number: 217-383-3170
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Mailing Address
-- DOMINIQUE K FONS MD
611 W. PARK ST BWPC
URBANA, IL 61803-6002
Phone number: 217-383-6792
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