Kimberly Davidson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015965 Issued in IL

Practice address

840 W Irving Park Rd Ste 302
Chicago, IL 60613-3011

Phone

(773) 659-9207

NPI assigned

Mar 18, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1730838715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W ELMDALE AVE UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604973",
            "telephone_number": "773-297-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "773-659-9207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 W Elmdale Ave Unit 1W",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606604973",
            "country_code": "US",
            "telephone_number": "773-297-1165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Davidson, MD
• Daja D Davidson
• Drevonte Davidson
• Joanna Wieczorek Davidson, M.D.
• Kelsey E Davidson, M.D.
• Laura Jean Davidson, M.D.
• Michael H Davidson
• Nathaniel Joel Davidson, PA-C
• Nicholas Davidson, MD, MS
• Ryan Davidson, PA-C

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.