Professional Diagnostic Service, S.C.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A-3920-0003-A Issued in IL

Legal business name

PROFESSIONAL DIAGNOSTIC SERVICE, S.C.

Practice address

821 W Van Buren St
Chicago, IL 60607-3517

Phone

(312) 491-0404

Fax

(312) 491-0505

NPI assigned

Aug 27, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth Davis, PH.D./MDNPI 1205040771

Title

President

Phone

(312) 491-0404

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth P Davis

  • Psychologist
  • Chicago, IL
  • NPI 1205040771
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1003063421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 W VAN BUREN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073517",
            "telephone_number": "312-491-0404",
            "fax_number": "312-491-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W VAN BUREN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073517",
            "telephone_number": "312-491-0404",
            "fax_number": "312-491-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DIAGNOSTIC SERVICE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-491-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D./MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-3920-0003-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Prodromou, LSW
• Eric John Proescher, PSY.D.
• Professional Anesthesiology Interventional Network, Inc (Chicago Pain Management Center)
• Professional Angel Care, LTD. (In-Home Professional Care Services)
• Professional Center Inc
• Professional Diagnostic, Inc.
• Professional Eye Center, PC
• Professional Foot Care Specialists, P.C.
• Professional Health Sport, Inc.
• Professional Home Care Advantage, Inc.

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.