Most Relevant Information
Provider Data
| NPI Number: | 1003684762 |
| Provider Name: | MARISSA GABONA DOMINGO-ZAHIRUDDIN RDN, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164008791 |
Most Important Dates
| Enumeration Date: | 12/12/2023 |
| Last Updated: | 12/12/2023 |
Provider Practice Location
8112 CRAWFORD AVE
SKOKIE
IL
600763330
Practice Location Phone/Fax
| Phone: | 7737879161 |
| Fax: |
Provider Mailing Location
8112 CRAWFORD AVE
SKOKIE
IL
600763330
Provider Mailing Phone/Fax
| Phone: | 7737879161 |
| Fax: |