Provider Type Icon

ANDREW AGEN DAVIS MD SC NPI 1598869224


NPI Information

NPI: 1598869224
Provider Name: ANDREW AGEN DAVIS, MD SC

Other Name: ANDY AGEN DAVIS, MD SC

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
8541 SO STATE STREET
SUITE 8
CHICAGO, IL
ZIP 60619
Phone: (773) 874-7711
Get Directions

ANDREW AGEN DAVIS, MD SC is a cardiovascular disease internal medicine in Chicago, IL. The provider is 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. ANDREW AGEN DAVIS, MD SC NPI is 1598869224. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Andy Agen Davis, Md Sc.

The provider's business location address is:

8541 SO STATE STREET
SUITE 8
CHICAGO, IL
ZIP 60619
Phone: (773) 874-7711
Fax: (773) 874-4721

The provider's authorized official is Andrew Agen Davis .
The authorized official title is President and has the following contact phone number (773) 874-7711.

The enumeration date for this NPI number is 9/12/2006 and was last updated on 2/6/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular Disease036054434ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1619390MEDICARE PINILLINOIS
2214044MEDICARE PINILLINOIS
3036054434MEDICAIDILLINOIS
4D13985MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.