Miguel Davis

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

101 Waukegan Rd Ste 1100
Lake Bluff, IL 60044-3013

Phone

(847) 247-2402

Fax

(847) 247-2405

NPI assigned

Aug 15, 2023

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1013790070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WAUKEGAN RD STE 1100",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600443013",
            "telephone_number": "847-247-2402",
            "fax_number": "847-247-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MIGUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dahl Crane, MSW
• Michelle Cruz
• Julie Marie Cummings, MSW, LCSW
• Dragana Cupic, MD
• Patricia Ann Daniels
• Silpa P Davuluri
• Deborahanne Reimer & Assoc. PLLC
• Jennifer M Degeus, MD
• Susan C Deney, APN-CNP
• Kaitlyn Marie Desimone, LCSW

• Physical Therapy Assistant in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.