Individual
RAYMOND A. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2000
Mailing address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-073340
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073340
—
IL
Enumeration date
08/30/2006
Last updated
01/29/2010
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