Organization
KDD VITAL HEALTH AND CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENISHA DAVIS (FNP)
(708) 655-1482
Entity
Organization
Contact information
Practice address
16266 PRINCE DR, SOUTH HOLLAND, IL 60473-3233
(708) 222-7333
(708) 221-0501
Mailing address
1393 BRANDYWINE RD, CROWN POINT, IN 46307-9307
(708) 655-1482
(708) 221-0501
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/14/2020
Last updated
09/06/2023
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