Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 036.146764 | IL |
Y | 208000000X | Pediatrician | 036.146764 | IL |
N | 2080P0201X | Pediatric Allergist | 036.146764 | IL |
NPI | 1881078616 |
---|---|
Provider Name | Dr. Stephannie Davies |
First Address | Elgin, IL 60120-4205 |
Second Address | Elgin, IL 60120-4205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 24/06/2020 |