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General NPI Number Information
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NPI Number | 1679416101
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Entity Type | Individual
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Provider Name | WARREN W DAVIS JR.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 500 S CLINTON ST APT 730
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City | CHICAGO
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State | IL
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Zip | 60607-4329
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Country | US
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Telephone | 815-557-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E ONTARIO ST FL 12
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City | CHICAGO
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State | IL
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Zip | 60611-3468
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Country | US
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Telephone | 312-469-4838
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Fax | 312-748-4503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041400738
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License Number State | IL
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