Davenport, Amanda C

Davenport, Amanda C is an individual health care provider with primary practice located at 9570 W 159Th St , Orland Park IL 60467-5504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Davenport, Amanda C can be contacted via phone (708) 675-7070.

Contact Information

Primary practice address
9570 W 159Th St Orland Park IL 60467-5504
Phone: (708) 675-7070
Fax: (708) 675-7074
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085003583 Illinois

Profile Details

NPI number 1922331354
LBN Legal business name Davenport, Amanda C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2009
Last updated Mar 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922331354 NPPES
Illinois Other 213992 GROUP PTAN
Illinois Other 204591 GROUP PTAN

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