Organization
PDSSC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH P DAVIS PH.D./MD (PRESIDENT)
(847) 729-9017
Entity
Organization
Contact information
Practice address
1877 WAUKEGAN RD, GLENVIEW, IL 60025-2158
(847) 729-9017
(847) 729-9047
Mailing address
1877 WAUKEGAN RD, GLENVIEW, IL 60025-2158
(847) 729-9017
(847) 729-9047
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A-4291-0001-A
IL
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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