Active NPI
Conswaila Sydnor Davis, LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1275040602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.011360
- Practice address
- 1525 E 55TH Street
Suite 301-B
Chicago, IL 60615-5581 - Phone
- (773) 841-3112
- Fax
- (773) 841-3112
- NPI assigned
- Jan 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.011360 | IL | Primary |
Addresses
Primary practice location
1525 E 55TH Street
Suite 301-B
Chicago, IL 60615-5581
Mailing address
6531 S Ingleside Ave
Chicago, IL 60637-4203
Phone (773) 841-3112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.011360 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515369600000",
"number": "1275040602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6531 S INGLESIDE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606374203",
"telephone_number": "773-841-3112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 E 55TH STREET",
"address_2": "SUITE 301-B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606155581",
"telephone_number": "773-841-3112",
"fax_number": "773-841-3112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYDNOR DAVIS",
"first_name": "CONSWAILA",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-08",
"last_updated": "2018-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.011360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.