Healthcare Provider Details

I. General information

NPI: 1053615492
Provider Name (Legal Business Name): INFINITY CARE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6857 S HALSTED ST
CHICAGO IL
60621-1833
US

IV. Provider business mailing address

1507 E 53RD ST SUITE 469
CHICAGO IL
60615-4573
US

V. Phone/Fax

Practice location:
  • Phone: 773-994-8244
  • Fax:
Mailing address:
  • Phone: 312-659-7812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FELICIA A DAVIS
Title or Position: CEO
Credential: MD
Phone: 312-659-7812