Organization
KAYE E. DAVIS, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYE E DAVIS MD (PRESIDENT)
(312) 939-4896
Entity
Organization
Contact information
Practice address
19110 DARVIN DRIVE, MOKENA, IL 60446
(708) 478-8507
(708) 478-8507
Mailing address
1448 E 52ND ST, # 396, CHICAGO, IL 60615-4122
(312) 939-4896
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932277
BLUE CROSS BLUE SHIELD
IL
01
—
DC5610
RAILROAD MEDICARE
IL
Enumeration date
12/05/2006
Last updated
10/08/2007
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