Healthcare Provider Details

I. General information

NPI: 1598398562
Provider Name (Legal Business Name): MRS. CASHAE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2410
US

IV. Provider business mailing address

1609 W COTTONWOOD LN APT 3M
MOUNT PROSPECT IL
60056-4924
US

V. Phone/Fax

Practice location:
  • Phone: 847-870-7711
  • Fax:
Mailing address:
  • Phone: 224-531-2718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: