ELDA JEAN DAVIS (NPI# 1003464926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003464926 |
| Entity Type | Individual |
| Full Name | ELDA JEAN DAVIS |
| Practice Address |
208 Juniper St Park Forest IL 60466 |
| Mailing Address |
Po Box 488 Park Forest IL 60466 |
| Practice Telephone | 7082028387 |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| Street Address |
208 JUNIPER ST |
| City | PARK FOREST |
| State | IL |
| Zip Code | 60466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558806224 | Cindy Okolo | Nurse Practitioner | 111 E Sycamore Drive Suite 303, Park Forest, IL 60466 | 2017-01-04 |
| 1063891984 | April Washington | Occupational Therapist | 2 Lakewood Ct, Park Forest, IL 60466 | 2015-05-26 |
| 1093940363 | Andrene Renee Johnson | Durable Medical Equipment & Medical Supplies | 3224 S Western Ave, Park Forest, IL 60466 | 2009-05-15 |
| 1316181597 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 101 Wolpers Rd, Park Forest, IL 60466 | 2009-05-01 |
| 1255504155 | Joyce N Onyenso | Registered Nurse | 1037 Monterey Ct, University Park, IL 60466 | 2008-04-11 |
| 1891812327 | Comgraph Inc. | Clinic/Center | 252 Main Street, Park Forest, IL 60466 | 2007-03-22 |
| 1992800890 | Village of Park Forest | Home Health | 350 Victory Drive, Lower Level, Park Forest, IL 60466 | 2006-09-14 |
| 1366468324 | Reliable Healthcare Service LLC | Registered Nurse | 220 Forest Blvd, Park Forest Blvd, IL 60466 | 2006-07-14 |
| 1881257806 | Healing Steps Counseling, PC | Clinic/Center | 230 Main St, Park Forest, IL 60466 | 2019-04-16 |
| 1508099540 | Maria Arenas | Radiologic Technologist | 150 Well Street, Park Forest, IL 60466-0000 | 2009-08-25 |
| Find all providers in zip 60466 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910505 | Tishieka Hollingsworth | Technician | 220 Forest Blvd, Park Forest, IL 60466-2032 | 2020-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294874 | Paulette Lovelace | Technician | 521 Vicksburg Dr, Belleville, IL 62221-6670 | 2020-10-28 |
| 1891395893 | Cheryl Lynn Eubanks | Technician | 1710 Mccasland Ave, East Saint Louis, IL 62207-2245 | 2020-10-28 |
| 1043818446 | Sabrina Marie Williams | Technician | 211 S Lodge St, Shelbyville, IL 62565-1951 | 2020-10-16 |
| 1124626213 | Tonya Lee Burdell | Technician | 315 S Douglas St, Litchfield, IL 62056-1851 | 2020-10-12 |
| 1720685704 | Itzayana Rodriguez | Technician | 5037 Carol Ct, Rockford, IL 61108-4157 | 2020-10-02 |
| 1871108209 | Ashley Marie Dawkins | Technician | 528 Grant Dr, Quincy, IL 62301-7234 | 2020-09-11 |
| 1104437797 | Stephen T Medford | Technician | 1017 Hartman Ln, O Fallon, IL 62269-7207 | 2020-08-16 |
| 1528685088 | Maxine Washington | Technician | 2014 S. 17th Ave., Broadview, IL 60155-2906 | 2020-07-01 |
| 1316562788 | Salli Jacobsen | Technician | 6699 Torch Lite Tr, Loves Park, IL 61111 | 2020-06-11 |
| 1356962377 | Brenda Lou Isermann | Technician | 406 W South 2nd St, Shelbyville, IL 62565-2114 | 2020-04-30 |
| Find all providers with the same taxonomy | ||||
| City | PARK FOREST |
| Zip Code | 60466 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.