Healthcare Provider Details

I. General information

NPI: 1528154879
Provider Name (Legal Business Name): GREGORY DAVIDSON D.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9045 KEELER AVE
SKOKIE IL
60076-1603
US

IV. Provider business mailing address

9045 KEELER AVE
SKOKIE IL
60076-1603
US

V. Phone/Fax

Practice location:
  • Phone: 847-224-9300
  • Fax: 847-675-3686
Mailing address:
  • Phone: 847-224-9300
  • Fax: 847-675-3686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: