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Deactivated NPI 1851371918 Deactivated / Inactive NPI Male Practitioner

Dr. Willard Davis , DO

Emergency Medicine • Chicago, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Willard Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 17, 2006
NPI Deactivation Date September 04, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Willard Davis, DO was a registered Emergency Medicine practicing in Chicago, IL. Throughout an active medical career spanning 19 years, Dr. Davis provided care at the practice location at 5645 W ADDISON ST until profile deactivation on 2025-09-04.

Historical Medicare Part B clinical services included emergency department visit for life threatening or functioning severity, routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, emergency department visit with moderate level of medical decision making. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

5645 W Addison St
Our Lady Of The Resurrection Hospital

Chicago, IL 606344403

Telephone 7732827000
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Emergency Medicine in Chicago, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.9 Yrs
State Avg: 24.6 Yrs
Regional Practice Density
1335 Specialists

Practicing in Chicago, IL (3389 Statewide)

Telehealth Adoption Rate
1.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
91.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
16 16 $1770.50 $158.39

Medical Specialties & State Licenses

Emergency Medicine Primary Specialty

NUCC Taxonomy Code: 207P00000X

State License IL 036112903

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003011966

Doctor of Medicine (M.D.)

Dr. Nicholas Morrell , DPT

Physical Therapist

NPI 1013684802

Doctor of Physical Therapy

Adekunle Adesuyi , CRNA

Nurse Anesthetist, Certified Registered

NPI 1073757803

Certified Registered Nurse Anesthetist

Brandee Grenda , RD, LDN

Dietitian, Registered

NPI 1093211153

Registered Dietitian, Licensed Dietitian Nutritionist

NPI 1134169717

Doctor of Medicine (M.D.)

Stephanie Anzelc

Nurse Anesthetist, Certified Registered

NPI 1184219164

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated September 04, 2025

Record deactivated on September 04, 2025

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2025

Emergency Medicine (License #036112903 in IL)

NPI Profile Active May 29, 2013

NPI status registered as active in NPPES database

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Updated Practice Location May 29, 2013

Registered at 5645 W ADDISON ST, OUR LADY OF THE RESURRECTION HOSPITAL, CHICAGO, IL 606344403 (Tel: 7732827000)

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Updated Business Mailing Address May 29, 2013

Registered at 933 W VAN BUREN ST APT 716, CHICAGO, IL 606073595 (Tel: 3124981195)

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Provider Name / Credentials Updated May 29, 2013

Recorded as WILLARD DAVIS, D.O.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2013

Emergency Medicine (License #036112903 in IL)

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Initial NPI Registration & Enumeration January 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851371918
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 17, 2006
Last Update: May 29, 2013
Deactivation Date: September 04, 2025

Mailing Address

933 W Van Buren St Apt 716

Chicago, IL 606073595

Phone: 3124981195

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.