Individual
TODD T DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 N HAVEN RD, SUITE 7, ELMHURST, IL 60126-2923
(630) 832-2111
(630) 832-5199
Mailing address
103 N HAVEN RD, SUITE 7, ELMHURST, IL 60126-2923
(630) 832-2111
(630) 832-5199
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036107390
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009900257
BCBS PROVIDER #
IL
05
—
036107390
—
IL
Enumeration date
09/12/2005
Last updated
01/31/2014
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