Individual
DR. ELLIOT WILLIAM DOMASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 996-4020
Mailing address
1740 W TAYLOR ST RM 3200W, CHICAGO, IL 60612-7232
(312) 996-4020
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
83722
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
07/29/2024
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