MEDICARE: SEAN P. DAVID 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	207Q00000X	Family Medicine Physician	036.148964	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	:	1942283825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN P. DAVID M.D.

Provider Business Mailing Address
First Line	:	9977 WOODS DR FL 1
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-1057
Country	:	US
Telephone Number	:	224-964-2273
Fax Number	:	847-663-8290

Provider Business Practice Location Address
First Line	:	9977 WOODS DR FL 1
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-1057
Country	:	US
Telephone Number	:	224-364-2273
Fax Number	:	847-663-8290

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	10/12/2021

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Directions to “ SEAN P. DAVID M.D.” Practice Location

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