Search › Illinois › 103T00000X
Kenneth Davis
NPI 1205040771 · on the registry since 2007
Practice
- Address
- 821 W Van Buren St
Chicago, IL 60607 - Phone
- (312) 491-0404
- Organisation at this address
- Professional Diagnostic Service, S.C.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Also registered as
- 103TC0700X
- Licence states on file
- WI, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-09-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois