Pdssc, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A-4291-0001-A Issued in IL

Legal business name

PDSSC, LLC

Practice address

1877 Waukegan Rd
Glenview, IL 60025-2158

Phone

(847) 729-9017

Fax

(847) 729-9047

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 P Davis, PH.D./MD

Title

President

Phone

(847) 729-9017

Specialties & licenses 1

Addresses

Locations

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": "1114174521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252158",
            "telephone_number": "847-729-9017",
            "fax_number": "847-729-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252158",
            "telephone_number": "847-729-9017",
            "fax_number": "847-729-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDSSC, LLC",
        "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_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-729-9017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D./MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-4291-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Delynn Pattullo, M.A. CCC-SLP
• Jessica Ann Paulose, OTR
• Shirley T Paulson
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• Anne Payne, OTR/L
• Katharine Peacock
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• Julie Ann Pearse, APRN, CNP
• Sally Pease, PTA
• Pediatric Consultation Center and Associates LLC

• Community/Behavioral Health Agency in Glenview, IL
• Providers in Glenview, 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.