Individual provider Active NPI

Richard M Davis, PA-C

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1770613713
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003204 Issued in IL
Practice address
4003 S Route 59
Naperville, IL 60564-5802
Phone
(888) 693-6437
Fax
(815) 730-6368
NPI assigned
Mar 7, 2007
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA911 KY
Physician Assistant 363A00000X 085-003204 IL Primary

Addresses

Primary practice location

4003 S Route 59
Naperville, IL 60564-5802

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

3205 Summit Square Pl Ste 100
Lexington, KY 40509-2636
Phone (859) 335-9041

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rdavis379373@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080919000594 IL Practitioner - Physician Assistant 3678640471 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1711 W Hwy 50
O Fallon, IL 62269-1681
Phone (618) 206-5076

2524 N Illinois St
Swansea, IL 62226-2353
Phone (618) 212-3144

2853 Kirk Rd
Aurora, IL 60502-6031
Phone (630) 423-3030

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

515 Belt Line Rd
Collinsville, IL 62234-4411
Phone (618) 381-9041

6050 Caton Farm Rd
Plainfield, IL 60586-8218
Phone (815) 609-5501

621 E Lincoln Hwy
New Lenox, IL 60451-1972
Phone (815) 907-5956

800 N Larkin Ave
Joliet, IL 60435-3429
Phone (815) 741-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA911KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Dec 3, 2024 Accepting new patients
Aurora Emergency Physicians, LLC CurrentSince Nov 22, 2017 Accepting new patients
University of Kentucky Hospital Past Accepting new patients
Marshall Emergency Services Associates, PLLC Physician Assistant Past Accepting new patients
Emergency Healthcare Physicians, LTD. Past Accepting new patients

Locations

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1770613713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 S ROUTE 59",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645802",
            "telephone_number": "888-693-6437",
            "fax_number": "815-730-6368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3205 Summit Square Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092636",
            "country_code": "US",
            "telephone_number": "859-335-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA911",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdavis379373@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4003 S Route 59",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605645802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.