Jacquelyn Hall-Davis, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036080270 Issued in IL

Practice address

1669 Windham Way Suite B
O'Fallon, IL 62269-3072

Phone

(618) 622-9240

Fax

(618) 622-9241

NPI assigned

Nov 21, 2006

Last updated

Feb 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacquelyn Hall-Davis,M.D. LTD

  • Child & Adolescent Psychiatry Physician
  • O'Fallon, IL
  • NPI 1699173542
  Authorized official Same address or phone

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1619042124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 WINDHAM WAY SUITE B",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "622693072",
            "telephone_number": "618-622-9240",
            "fax_number": "618-622-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 WINDHAM WAY SUITE B",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "622693072",
            "telephone_number": "618-622-9240",
            "fax_number": "618-622-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL-DAVIS",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036080270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080270",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO",
            "identifier": "3649",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Haas, PT, DPT
• Peyton Lynn Haas, RBT
• Brynn Hackney, ATC, LAT
• Timothy Edward Hackney, D.C.
• Todd Christopher Hackney, D.C.
• Abigail Haloftis, B.S.
• Keri Halwachs, RBT
• Whitney Hames, BS, RDN
• David Scott Hamilton, M.S. CCC-SLP
• Kara Hamilton

• Child & Adolescent Psychiatry Physician in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.