Individual
MAHOGANY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3115 HERITAGE BLVD, MATTESON, IL 60443-4450
(773) 383-5382
Mailing address
3115 HERITAGE BLVD, MATTESON, IL 60443-4450
(773) 383-5382
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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