MEDICARE: ROBERT F. DAVIS D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician		IL

General Provider Information

NPI Number	:	1134140668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT F. DAVIS D.O.

Provider Business Mailing Address
First Line	:	1306 PLAINFIELD RD
Second Line	:
City	:	DARIEN
State	:	IL
Zip	:	60561-5038
Country	:	US
Telephone Number	:	630-810-0900
Fax Number	:	630-810-1037

Provider Business Practice Location Address
First Line	:	1306 PLAINFIELD RD
Second Line	:
City	:	DARIEN
State	:	IL
Zip	:	60561-5038
Country	:	US
Telephone Number	:	630-810-0900
Fax Number	:	630-810-1037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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