Organization
DAVISON-MCNEAL SC
Active
Other names
Davison-McNeal SC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIBIBI DAVISON DPM (OWNER)
(773) 641-1489
Entity
Organization
Contact information
Practice address
6330 S INGLESIDE AVE, UNIT 1, CHICAGO, IL 60637-3620
(773) 641-1489
Mailing address
6330 S INGLESIDE AVE, UNIT 1, CHICAGO, IL 60637-3620
(773) 641-1489
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005441
IL
Other
Enumeration date
09/12/2013
Last updated
11/05/2013
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