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Individual

KEITHA DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC, FPA

Contact information

Practice address
1009 S WOOD ST FL 2, CHICAGO, IL 60612-3747
(312) 996-2779
(312) 355-2983
Mailing address
1009 S WOOD ST FL 2, CHICAGO, IL 60612-3747
(312) 996-2779
(312) 355-2983

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277001627
IL
363LF0000X
Family Nurse Practitioner
277001627
IL

Other

Enumeration date
01/14/2018
Last updated
04/10/2025
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