Individual provider · Type 1 NPI

Kirk Wagner Davis

Student in an Organized Health Care Education/Training Program · Park Ridge, IL

NPI number 1679462543 Active

Practice location

1110 S Washington Ave
Park Ridge, IL 60068-4815

Call (773) 497-9417 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1679462543

Kirk Wagner Davis's National Provider Identifier is 1679462543, issued on Jul 2, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Park Ridge, IL. The record was last updated on Jul 2, 2025.