Davenport Medical INC

NPI #1619603065 in Oak Park, Illinois

Provider Information

NPI Number: 1619603065
Entity Type: Organization
Organization Name: Davenport Medical INC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 28, 2022
Last Updated: Jul 28, 2022

Practice Location

Address: 1023 MAPLETON AVE
City: Oak Park
State: Illinois
ZIP Code: 60302-1405
Phone: (773) 543-8964

Authorized Official

Name: DR. TRACEY DAVENPORT, MD
Title: PRESIDENT/AUTHORIZED OFFICIAL
Phone: (773) 543-8964

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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