Individual
THERESA A DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1506 SPRING ST, GREENWOOD, SC 29646-4071
(864) 725-7900
(864) 725-7910
Mailing address
12251 S 80TH AVE STE 1520, PALOS HEIGHTS, IL 60463-1290
(708) 923-4200
(708) 923-4201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011269
IL
363A00000X
Physician Assistant
1544
NH
363A00000X
Physician Assistant
4837
SC
363A00000X
Physician Assistant
PA9110282
FL
363AS0400X
Surgical Physician Assistant
1761
TN
Other
Enumeration date
08/28/2009
Last updated
06/24/2025
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