Davis, Todd T
Davis, Todd T is an individual health care provider with primary practice located at 103 N Haven Rd Suite 7, Elmhurst IL 60126-2923. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Davis, Todd T can be contacted via phone (630) 832-2111.Contact Information
Primary practice address
103 N Haven Rd Suite 7
Elmhurst IL 60126-2923
Phone: (630) 832-2111
Fax: (630) 832-5199
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036107390 | Illinois |
Profile Details
NPI number | 1629063169 |
---|---|
LBN Legal business name | Davis, Todd T |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 12th, 2005 |
Last updated | Jan 31st, 2014 - about 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629063169 | NPPES |
Illinois | Other | 009900257 | BCBS PROVIDER # |
Illinois | MEDICAID | 036107390 | BCBS PROVIDER # |
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