MEDICARE: DR. LLOYD S DAVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	036057378	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902884596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LLOYD S DAVIS M.D.

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE RM 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:	847-733-5315

Provider Business Practice Location Address
First Line	:	2180 PFINGSTEN RD STE 2000
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1339
Country	:	US
Telephone Number	:	847-570-2570
Fax Number	:	847-657-5708

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	02/11/2021

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