Individual
KRISTIN D DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2285 SEQUOIA DR, AURORA, IL 60506-6209
(630) 859-6700
Mailing address
28594 NETWORK PL, CHICAGO, IL 60673-1285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036105734
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105734
—
IL
01
—
075914
HEALTH ALLIANCE MEDICAL
IL
01
—
9815737
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/13/2006
Last updated
01/30/2025
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