Provider Demographics
NPI:1841334059
Name:DAVIS, HILARY M
Entity type:Individual
Prefix:MRS
First Name:HILARY
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N FAIRWAY DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1861
Mailing Address - Country:US
Mailing Address - Phone:773-450-4541
Mailing Address - Fax:773-996-6665
Practice Address - Street 1:200 N FAIRWAY DR
Practice Address - Street 2:SUITE 208
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1861
Practice Address - Country:US
Practice Address - Phone:773-450-4541
Practice Address - Fax:773-996-6665
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist