Healthcare Provider Details

I. General information

NPI: 1003700907
Provider Name (Legal Business Name): DAVID WOODS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 DOUGLAS AVE STE 273
ELGIN IL
60120-5590
US

IV. Provider business mailing address

11 DOUGLAS AVE STE 273
ELGIN IL
60120-5590
US

V. Phone/Fax

Practice location:
  • Phone: 847-595-0620
  • Fax:
Mailing address:
  • Phone: 847-595-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209032463
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: