Provider Demographics
NPI:1801072558
Name:ROSS-DAVIS, SYDNEY VICTORIA (MD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:VICTORIA
Last Name:ROSS-DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E RANDOLPH ST
Mailing Address - Street 2:OFFICE 24-103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5014
Mailing Address - Country:US
Mailing Address - Phone:312-653-5749
Mailing Address - Fax:
Practice Address - Street 1:300 E RANDOLPH ST
Practice Address - Street 2:OFFICE 24-103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5014
Practice Address - Country:US
Practice Address - Phone:312-653-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine