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EDRENA DAVIS
NPI 1619313889
Behavior Analyst in Hazel Crest, IL

Active since May 15, 2013PECOS Enrolled
1909 CHEKER SQ, HAZEL CREST, IL 60429(708) 331-0500 Get Directions Write a Review

NPPES record last updated: May 15, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Edrena Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDRENA DAVIS (NPI 1619313889) is an individual behavior analyst provider in Hazel Crest, Illinois and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1619313889
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameEDRENA DAVIS
Location Address1909 CHEKER SQHazel Crest, IL 60429-1442
Mailing Address1909 Cheker SqHazel Crest, IL 60429-1442
Phone(708) 331-0500
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateMay 15, 2013
✔ NPI 1619313889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
1909 CHEKER SQ, Hazel Crest, IL 60429
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edrena Davis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658666110
PECOS Enrollment IDI20160823000824
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Edrena Davis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Advanced Clinical Health Service Corporation
19 mi
Clinical
2925 S WABASH AVE STE 102
Chicago, IL 60616
  • Reassigned Medicare billing, Illinois enrollment
NPI 1891200317 (773) 879-2274

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. DANA MARIE AIKENS CSADC, MISAI, ATE
Counselor (Addiction (Substance Use Disorder))
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 647-3371
JASMINE CARTER
Counselor (Addiction (Substance Use Disorder))
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 647-3333
TIMOTHY BROWN BA, CADC
Counselor (Addiction (Substance Use Disorder))
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 647-3333
MARIAH MURPHY
Social Worker
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (866) 477-8632
BARBARA JULIAN
Counselor (Addiction (Substance Use Disorder))
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 647-3331
CRYSTAL BERYMON
Case Manager/Care Coordinator
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 444-1012
VICTORIA MORADEYO ADELEKE
Counselor (Addiction (Substance Use Disorder))
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 647-3333
LIZ FRAUSTO B.A.
Counselor (Addiction (Substance Use Disorder))
1909 CHEKER SQ
EAST HAZEL CREST, IL 60429
Cook County (708) 647-3343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edrena Davis's NPI number?

The NPI number for Edrena Davis is 1619313889. It was assigned to this individual provider in the NPPES registry on May 15, 2013.

Where is Edrena Davis located?

Edrena Davis practices at 1909 Cheker Sq, Hazel Crest, IL 60429. The listed phone number is (708) 331-0500.

What is Edrena Davis's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Is Edrena Davis enrolled in Medicare?

Yes. Edrena Davis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Edrena Davis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edrena Davis reassigns Medicare benefits to Advanced Clinical Health Service Corporation (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edrena Davis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Edrena Davis was last updated on May 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.