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:
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Health care specialties

SpecialtyCodeLicense #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 10 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 1629063169 NPPES
Illinois Other 009900257 BCBS PROVIDER #
Illinois MEDICAID 036107390 BCBS PROVIDER #

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