1356307367 NPI number — DR. ZEV DAVIS MD

Table of content: DR. ZEV DAVIS MD (NPI 1356307367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356307367 NPI number — DR. ZEV DAVIS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIS
Provider First Name:
ZEV
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356307367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2650 WARRENVILLE RD
Provider Second Line Business Mailing Address:
STE 280
Provider Business Mailing Address City Name:
DOWNERS GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-324-7900
Provider Business Mailing Address Fax Number:
630-324-7942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 S WASHINGTON
Provider Second Line Business Practice Location Address:
4TH FLR
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-416-8500
Provider Business Practice Location Address Fax Number:
630-416-8694
Provider Enumeration Date:
04/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  J538787 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208G00000X , with the licence number: 01030832A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208G00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 526620 . This is a "COOK GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36060900 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 344390 . This is a "DU PAGE GROUP" identifier . This identifiers is of the category "OTHER".