SHADEQUIA DAVIS (NPI# 1033724232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033724232 |
| Entity Type | Individual |
| Full Name | SHADEQUIA DAVIS |
| Credential | MS, NCSP |
| Practice Address |
402 Richards St Joliet IL 60433-2218 |
| Mailing Address |
1440 S Michigan Ave Apt 312 Chicago IL 60605-2956 |
| Practice Telephone | 8157275271 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
2489765 | IL | Behavioral Health & Social Service Providers |
| Street Address |
402 RICHARDS ST |
| City | JOLIET |
| State | IL |
| Zip Code | 60433-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710105978 | Aparna Gottumukkula | Dentist | 1106 Neal Avenue, Joliet, IL 60433 | 2007-04-23 |
| 1932114758 | County of Will | Clinic/Center | 501 Ella Ave, Joliet, IL 60433 | 2006-07-30 |
| 1346481082 | Will County Health Dept | Clinic/Center | 501 Ella Ave, Joliet, IL 60433 | 2009-03-10 |
| 1588819544 | Will County Health Department | Clinic/Center | 501 Ella Ave, Joliet, IL 60433 | 2008-11-18 |
| 1982176285 | Anita Lomax | Assistant Behavior Analyst | 206 E Washington St Apt A, Joliet, IL 60433-1006 | 2018-12-26 |
| 1447723275 | Aba Everyday LLC | Community/Behavioral Health | 206 E Washington St Apt A, Joliet, IL 60433-1006 | 2019-01-03 |
| 1245366483 | Morningstar Counseling | Counselor | 350 E Washington St, Joliet, IL 60433-1150 | 2007-02-24 |
| 1053911479 | Demitrius Brackett | Clinic/Center | 350 E Washington St, Joliet, IL 60433-1150 | 2020-10-26 |
| 1326541566 | Ready To Go LLC | Non-emergency Medical Transport (VAN) | 119 Logan Ave, Joliet, IL 60433-1262 | 2018-03-14 |
| 1215223755 | Kodo Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1522 E Washington St, Joliet, IL 60433-1365 | 2011-06-23 |
| Find all providers in zip 60433 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967457 | Jamie Elkhoury | Psychologist | 251 N Midland Ave, Joliet, IL 60435-6837 | 2020-09-16 |
| 1356996128 | Matthew Malone | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2019-08-07 |
| 1619530672 | Megan Bowman | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2019-04-16 |
| 1104389725 | Lauren Buck | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2019-04-10 |
| 1891267514 | Tracy Ward | Psychologist | 201 E Jefferson St, Joliet, IL 60432-2841 | 2018-12-19 |
| 1952805996 | Lawrence Rieger | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2018-03-23 |
| 1285140681 | Monica Cisneros | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2017-12-20 |
| 1922514777 | Nicole Marie Villarreal | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2017-12-15 |
| 1184130932 | Storm Maria Kline | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2017-12-15 |
| 1396251237 | Andrea Gandy | Psychologist | 420 N Raynor Ave, Joliet, IL 60435-6065 | 2017-12-14 |
| Find all providers in JOLIET | ||||
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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.