Provider Demographics
NPI:1457393159
Name:DAVKEN ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DAVKEN ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:FILS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-673-0718
Mailing Address - Street 1:PO BOX 9220
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60598-9220
Mailing Address - Country:US
Mailing Address - Phone:630-362-9192
Mailing Address - Fax:847-673-0875
Practice Address - Street 1:822 MEADOWRIDGE DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5356
Practice Address - Country:US
Practice Address - Phone:630-362-9192
Practice Address - Fax:847-673-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211169Medicare ID - Type UnspecifiedGROUP NUMBER
IL377040Medicare ID - Type UnspecifiedGROUP NUMBER
IN151860Medicare ID - Type UnspecifiedGROUP NUMBER
IL795480Medicare ID - Type UnspecifiedGROUP NUMBER