Healthcare Provider Details

I. General information

NPI: 1043180532
Provider Name (Legal Business Name): EMILY DAVIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1S 376 SUMMIT AVE STE 5B
OAKBROOK TERRACE IL
60181
US

IV. Provider business mailing address

1S 376 SUMMIT AVE STE 5B
OAKBROOK TERRACE IL
60181
US

V. Phone/Fax

Practice location:
  • Phone: 224-300-4268
  • Fax:
Mailing address:
  • Phone: 224-300-4268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.011881
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number085.011881
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: