Individual provider Active NPI

Vanessa Davis, MD

  • Pediatric Endocrinology Physician
  • Chicago, IL
National Provider Identifier
1982856118
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
036107957 Issued in IL
Practice address
1900 W Polk St
C/O Dr David Soglin,Suite 1100
Chicago, IL 60612-3723
Phone
(312) 864-4506
Fax
(312) 864-4506
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-107957 IL
Pediatric Endocrinology Physician 2080P0205X 036107957 IL Primary

Addresses

Primary practice location

1900 W Polk St
C/O Dr David Soglin,Suite 1100
Chicago, IL 60612-3723

Mailing address

1900 W Polk St
Suite 1144
Chicago, IL 60612-3723
Phone (312) 864-4172

Other practice location 1

1801 W Taylor St
Chicago, IL 60612-4795
Phone (312) 996-7416

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vdavis3@direct.ccprovider.org Direct Cook County

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000820 IL Practitioner - Pediatric MedicinePractitioner - Endocrinology 6709068398 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-107957ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 1, 2022 Accepting new patients
Cook County CurrentSince Nov 23, 2010 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Jan 1, 2022 Accepting new patients
Cook County CurrentSince Nov 23, 2010 Accepting new patients
Cook County Current Accepting new patients

Locations

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

1725 W Harrison St
Ste 710
Chicago, IL 60612
Phone (312) 942-5983

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1653 W Congress Pkwy
#622
Chicago, IL 60612
Phone (312) 942-5068

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

Interoperability endpoints

  • Direct secure messaging: vdavis3@direct.ccprovider.org

Organizations & group practices 6

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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1982856118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "address_2": "SUITE 1144",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-4172",
            "fax_number": "312-864-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "address_2": "C/O DR DAVID SOGLIN,SUITE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-4506",
            "fax_number": "312-864-4506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-996-7416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-107957",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036107957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vdavis3@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.