Healthcare Provider Details

I. General information

NPI: 1225128200
Provider Name (Legal Business Name): SUSAN DAVIES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAVIES FERTILITY & IVF SPECIALISTS S.C. 2640 PATROIT BOULEVARD SUITE 260
GLENVIEW IL
60026
US

IV. Provider business mailing address

DAVIES FERTILITY & IVF SPECIALISTS S.C. 2640 PATROIT BOULEVARD SUITE 260
GLENVIEW IL
60026
US

V. Phone/Fax

Practice location:
  • Phone: 847-972-0300
  • Fax: 847-972-0043
Mailing address:
  • Phone: 847-972-0300
  • Fax: 847-972-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number036-048439
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: