Organization
PDSSC-CHICAGO, INC.
Active
Other names
Professional Diagnostic Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH P DAVIS MD, PH.D (PRESIDENT)
(773) 772-2450
Entity
Organization
Contact information
Practice address
2260 N ELSTON AVE, CHICAGO, IL 60614
(773) 772-2450
Mailing address
2260 N ELSTON AVE, CHICAGO, IL 60614-2930
(773) 772-2450
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
A-3407-0001-A
IL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
A-3407-0001-A
IL
Other
Enumeration date
05/10/2007
Last updated
10/06/2025
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