Ann Bacon Davidsen, OTR/L

Primary specialty

SpecialistTaxonomy code 174400000X

License

056.001865 Issued in IL

Practice address

600 N Bradley Rd
Lake Forest, IL 60045-1020

Phone

(847) 615-8696

NPI assigned

Jun 24, 2009

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1982832382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 S MILWAUKEE AVE # 273",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N BRADLEY RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451020",
            "telephone_number": "847-615-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSEN",
        "first_name": "ANN",
        "middle_name": "BACON",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "056.001865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Dammrich, M.D.
• Jennifer Ann Daniels, MA
• Tricia Valters Danz, O.D.
• David E. Schmidt, D.D.S., P.C.
• David Vigder MD SC
• Daniel Guillermo Davila, M.D.
• Benjamin Davis, M.D.
• Linda K. Davis, M ED
• Daniela Yvonne Dawson
• Colleen Marie Deboer, RD, LDN, CDE

• Specialist in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.