Ely, Dominique

Ely, Dominique is an individual health care provider with primary practice located at 747 N Rutledge St Fl 4 , Springfield IL 62702-6700. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Ely, Dominique can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
747 N Rutledge St Fl 4 Springfield IL 62702-6700
Phone: (217) 545-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 209011112 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209011112 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 209011112 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209011112 Illinois

Profile Details

NPI number 1629490081
LBN Legal business name Ely, Dominique
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2014
Last updated Jun 8th, 2023 - about 2 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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