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Contact Information

DOMICA S LIGHT
202 W PARK AVE
CHAMPAIGN, IL61820-3929
 Phone: 217-373-2430
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
Indicates primary specialty

NPI Profile & details for DOMICA S LIGHT · (Female)

NPI # 1972890499
Status Active
Credentials
Entity Individual
Enumeration date 07/05/2011
Last updated 07/05/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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