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Contact Information

JACQUELYN HALL-DAVIS,M.D. LTD
1669 WINDHAM WAY
SUITE B
O'FALLON, IL62269-3072
 Phone: 618-622-9240
 Fax: 618-622-9241
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JACQUELYN HALL DAVISMD LTD · (Female)

NPI Number 1699173542
Status Active
Credentials
Entity Individual
Enumeration date 12/09/2014
Last updated 12/09/2014 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 036080270
  • IL Medicaid 036080270
  • IL Other 540653 TRICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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