Individual
DR. DOMINIC JOSEPH GRISAFE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
820 S WOOD ST, CHICAGO, IL 60612-4325
(312) 996-2933
(312) 996-3050
Mailing address
820 S WOOD ST, CHICAGO, IL 60612-4325
(312) 996-2933
(312) 996-3050
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1962197160
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2023
Last updated
09/11/2023
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