Individual
MR. ZACKARY CHARLES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
6526 N. WINTHROP AVENUE, CHICAGO, IL 60626
(773) 508-2383
Mailing address
1137 OAK AVE, EVANSTON, IL 60202-1252
(513) 720-5140
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004311
IL
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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