Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Ely, AGACNP-BC

Individual provider Nurse Practitioner · NPI 1629490081

Dominique Ely, AGACNP-BC is a Nurse Practitioner in Decatur, Illinois. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 2013, 13 years ago. Practices with SIU Physicians and Surgeons Inc, a 316-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
13
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
IL
In the registry since
2014
Specialties on file
4

Practice location Address checks out

302 W Hay St Ste 140
Decatur, IL 62526-4168
Phone: (217) 872-2713
Fax: (217) 545-1958
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 747 N Rutledge St Fl 4, Springfield, IL 62702-6700 — (217) 545-8000
  • 611 W Park St, Urbana, IL 61801-2500 — (217) 383-3129

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 209011112 (IL)
Nurse Practitioner Taxonomy 363L00000X · Licence 209011112 (IL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 209011112 (IL)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 209011112 (IL)

Record details

NPI number1629490081
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedJanuary 20, 2014
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 2013 (13 years in practice)
Group practice Siu Physicians And Surgeons Inc — 316 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Decatur