Provider Demographics
NPI:1386618296
Name:DAVIS, ADAM C (MS, ATC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9512 KARLOV AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1419
Mailing Address - Country:US
Mailing Address - Phone:847-673-0357
Mailing Address - Fax:484-993-9689
Practice Address - Street 1:9512 KARLOV AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1419
Practice Address - Country:US
Practice Address - Phone:847-929-4660
Practice Address - Fax:484-993-9689
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer