Individual
SARAH D DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDM
Contact information
Practice address
719 N MARION ST, OAK PARK, IL 60302-1530
(844) 478-6878
Mailing address
1544 W GLENLAKE AVE APT 5A, CHICAGO, IL 60660-1872
(773) 816-7624
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D120-7849-7928
DRIVERS LICENSE
IL
Enumeration date
06/29/2021
Last updated
06/29/2021
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