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Individual

MR. MARK DAVID DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSW

Contact information

Practice address
19201 S LA GRANGE RD STE 204, MOKENA, IL 60448-8014
(708) 287-0816
Mailing address
17500 CLOVERVIEW DR, TINLEY PARK, IL 60477-6587
(708) 274-6126

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
D12054490233
IL
104100000X
Social Worker
Primary
150.116888
IL
1041S0200X
School Social Worker
2536151
IL

Other

Enumeration date
06/18/2013
Last updated
07/01/2025
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