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General NPI Number Information
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NPI Number | 1679596456
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Entity Type | Individual
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Provider Name | RAOUL JEFFREY DAVION M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 8012 S CRANDON AVE
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City | CHICAGO
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State | IL
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Zip | 60617-1124
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Country | US
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Telephone | 773-356-5415
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Fax | 773-356-5415
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Provider Business Mailing Address
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Address Line | 1546 W JACKSON BLVD
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City | CHICAGO
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State | IL
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Zip | 60607-5304
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Country | US
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Telephone | 773-356-5415
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Fax | 773-356-5415
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036043384
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License Number State | IL
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