| Charles E. Davis, Ph.d., P.c. | |
|
1010 Lake St Suite 109 Oak Park IL 60301-1147 | |
| (708) 431-2245 | |
| (708) 383-0198 |
| Full Name | Charles E. Davis, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1010 Lake St, Oak Park, Illinois |
| Authorized Official Name and Position | Charles E. Davis (PRESIDENT AND REGISTERED AGENT) |
| Authorized Official Contact | 7084312245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles E. Davis, Ph.d., P.c. 1010 Lake St Suite 109 Oak Park IL 60301-1147 Ph: (708) 431-2245 | Charles E. Davis, Ph.d., P.c. 1010 Lake St Suite 109 Oak Park IL 60301-1147 Ph: (708) 431-2245 |
| NPI Number | 1619285269 |
|---|---|
| Provider Enumeration Date | 09/16/2010 |
| Last Update Date | 09/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619285269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071003271 (Illinois) | Primary |
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