ANDREW AGEN DAVIS, MD SC (NPI# 1598869224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598869224 |
| Entity Type | Organization |
| Organization Name | ANDREW AGEN DAVIS, MD SC |
| Other Organization Name | ANDY AGEN DAVIS, MD SC |
| Practice Address |
8541 So State Street Suite 8 Chicago IL 60619 |
| Mailing Address |
8541 South State Street Suite 8 Chicago IL 60619 |
| Practice Telephone | 7738747711 |
| Practice Fax Number | 7738744721 |
| Mailing Telephone | 7738747711 |
| Mailing Fax Number | 7738744721 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2015-02-06 |
| Authorized Official Name | ANDREW AGEN DAVIS (PRESIDENT) |
| Authorized Official Telephone | 7738747711 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036054434 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036054434 | 05 |
| Other Name | Type Code |
|---|---|
| Andy Agen Davis, MD SC | Other Name - Individual/Organization |
| Street Address |
8541 SO STATE STREET SUITE 8 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457985061 | Tonia Dorsey | Durable Medical Equipment & Medical Supplies | 951 E 80th Street, Apt 1, Chicago, IL 60619 | 2020-02-24 |
| 1821635509 | Lisa Strader | Technician | 8605 S. Dorchester, Chicago, IL 60619 | 2019-12-02 |
| 1821647579 | Deborah Joves | Technician | 8258 S. Woodlawn Ave, Chicago, IL 60619 | 2019-09-05 |
| 1194372458 | Cognitive Focus Centers, Inc. | Clinic/Center | 901 E 95th St, Chicago, IL 60619 | 2019-08-21 |
| 1588136360 | Zantraquilla Z Madkins | Transportation Broker | 7829 South Wabash, Chicago, IL 60619 | 2018-12-18 |
| 1619447497 | Bria Stanciel | Case Manager/Care Coordinator | 8419 S Cottage Grove, Chicago, IL 60619 | 2018-12-05 |
| 1184153520 | Jordane Kelley | Nurse's Aide | 7339 S Wabash Ave, Chicago, IL 60619 | 2017-06-08 |
| 1205362977 | Kristen Suing | Psychologist | 1111 E 87th St Ste 300, Chicago, IL 60619 | 2017-05-02 |
| 1720525280 | Senior Healthcare Services Inc | Physical Therapist | 9133 South Stoney Island, Chicago, IL 60619 | 2017-01-23 |
| 1932652567 | Md Orthotic & Prosthetic Laboratory, Inc. | Prosthetic/Orthotic Supplier | 1514 E 87th St Lowr Level, Chicago, IL 60619 | 2016-08-01 |
| Find all providers in zip 60619 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427457399 | Charles Joseph Frahm | Internal Medicine | 1200 E Madison Park, Chicago, IL 60615-2961 | 2014-08-17 |
| 1225447725 | Jeremy R. Estrada | Internal Medicine | 5841 S Maryland Ave # Mc5841, Chicago, IL 60637-1447 | 2014-08-08 |
| 1285049197 | Nidhi Madan | Internal Medicine | 1717 W Congress Pkwy Ste 317, Chicago, IL 60612 | 2014-06-30 |
| 1588097596 | Atif Khawaja Hassan | Internal Medicine | 5140 N California Ave Ste 740, Chicago, IL 60625-7066 | 2013-08-13 |
| 1952651382 | Rajeev Ruben Fernando | Internal Medicine | 365 N Jefferson St, 2712, Chicago, IL 60661-1226 | 2012-09-13 |
| 1174888945 | Mohammad Tarek Kabbany | Internal Medicine | 676 N Saint Clair St Ste 7-730, Chicago, IL 60611-2927 | 2012-07-09 |
| 1740589175 | United Diagnostic Services, LLC | Internal Medicine | 6124 N Milwaukee Ave Ste 2, Chicago, IL 60646-3820 | 2011-03-24 |
| 1932361433 | Sanjay S Gill | Internal Medicine | 2266 N. Lincoln Ave., 3, Chicago, IL 60614 | 2008-06-26 |
| 1053571208 | Curewell Diagnostic Services LLC | Internal Medicine | 6124 N Milwaukee Ave Ste 1, Chicago, IL 60646-3820 | 2008-06-11 |
| 1972760718 | Steve Attanasio | Internal Medicine | 1725 W Harrison St Ste 1159, Chicago, IL 60612 | 2008-05-20 |
| Find all providers in CHICAGO | ||||
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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.