Timothy A Davidson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

1640 Willow Circle Dr
Ste. #400
Crest Hill, IL 60435-0959

Phone

(815) 729-9922

Fax

(815) 729-9933

NPI assigned

May 10, 2006

Sex

Male

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 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Davidson Chiropractic Clinic PC

  • Chiropractor
  • Crest Hill, IL
  • NPI 1285854877
  NPD (past) Authorized official

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982654240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 WILLOW CIRCLE DR",
            "address_2": "STE. #400",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604350959",
            "telephone_number": "815-729-9922",
            "fax_number": "815-729-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 WILLOW CIRCLE DR",
            "address_2": "STE. #400",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604350959",
            "telephone_number": "815-729-9922",
            "fax_number": "815-729-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "653965",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7643227",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "653965",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "12143864",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "2115623",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "9932155",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST HEALTH",
            "identifier": "P3297300",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crest Hill Clinic LTD
• Crest Hill Dental Studio
• Lisa Damani, PHARMD
• Mary Kay Darin
• Davidson Chiropractic Clinic PC
• Mary A Davis, LCSW
• Noemi Delgado, RBT-18-49906
• Jenalee Demarco, SLP
• Dental Starz 3 L.L.C
• James F Derk, D.P.M.

• Chiropractor in Crest Hill, IL
• Providers in Crest Hill, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.