NPI 1588039556

Bianca Davis, LPN

Practitioner Psychiatric Residential Treatment Facility Homewood, IL

Practice location

Address: 18610 Morris Ave, Homewood, IL 60430-3628
Phone: (708) 860-2143

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence 043.110334 (IL)

Other Psychiatric Residential Treatment Facility providers in Illinois →

Registry record

NPI: 1588039556
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Dec 2015
Record last updated: 2 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.