Davison, Daniel Thomas

Davison, Daniel Thomas is an individual health care provider with primary practice located at 6500 W 65Th St , Chicago IL 60638-4962. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Davison, Daniel Thomas can be contacted via phone (708) 496-1515.

Contact Information

Primary practice address
6500 W 65Th St Chicago IL 60638-4962
Phone: (708) 496-1515
Fax: (708) 495-1788
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036059839 Illinois

Profile Details

NPI number 1750431870
LBN Legal business name Davison, Daniel Thomas
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Jan 26th, 2017 - about 8 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 1750431870 NPPES
Illinois MEDICAID 036059839

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