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RAFIE DAVIDOV A.P.N.-C.N.P. NPI 1649712373


NPI Information

NPI: 1649712373
Provider Name: RAFIE DAVIDOV, A.P.N.-C.N.P.
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
800 BIESTERFIELD RD STE G01
WIMMER BUILDING
ELK GROVE VILLAGE, IL
ZIP 60007
Phone: (847) 981-3680
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Rafie Davidov, A.P.N.-C.N.P. is a gerontology nurse practitioner in Elk Grove Village, IL with 8 years of experience. Rafie Davidov, A.P.N.-C.N.P. NPI is 1649712373. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:2016

The provider's business location address is:

800 BIESTERFIELD RD STE G01
WIMMER BUILDING
ELK GROVE VILLAGE, IL
ZIP 60007-372
Phone: (847) 981-3680
Fax: (847) 956-5122

The NPI 1649712373 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/11/2016 and was last updated on 11/11/2016.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LG0600XNurse PractitionerGerontology209014789ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11720371669OTHERILLINOISGROUP PRACTICE NPI

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: 5/5/2024

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.