Davis, Lori Ellen

Davis, Lori Ellen is an individual health care provider with primary practice located at 201 W Springfield Ave Suite 503, Champaign IL 61820-4834. She recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as her primary health care specialty. Davis, Lori Ellen can be contacted via phone (217) 398-8888.

Contact Information

Primary practice address
201 W Springfield Ave Suite 503 Champaign IL 61820-4834
Phone: (217) 398-8888
Fax: (217) 398-8887
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X Illinois

Profile Details

NPI number 1881672616
LBN Legal business name Davis, Lori Ellen
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1881672616 NPPES
Illinois Other 0001032074 BLUE CROSS/BLUE SHIELD

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