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Individual

EMILY DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4417 W DIVERSEY AVE, CHICAGO, IL 60639
(773) 377-7736
(815) 642-5723
Mailing address
PO BOX 746721, ATLANTA, GA 30374-6721
(312) 733-9730
(773) 866-8014

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016460
IL

Other

Enumeration date
09/05/2017
Last updated
10/01/2020
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