DR. KENNETH PAUL DAVISON (PSY.D.) – Clinical Psychologist, NPI 1104844240
Clinical Psychologist
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Profile Insights
NPPES metrics only — not quality of care.
1,600 CLINICAL PSYCHOLOGIST in IL
Provider Addresses for DR. KENNETH PAUL DAVISON (PSY.D.)
610, West Roosevelt Road, Wheaton, DuPage County, Illinois, 60187, United States
SUITE B-1
WHEATON, IL 601875087
Phone: (630) 462-3999
Fax: (630) 462-0911
Type: Mailing
29373 NETWORK PL
CHICAGO, IL 606731293
Phone:
Type: Mailing
1341 WARREN AVE
DOWNERS GROVE, IL 605153437
Phone: (630) 719-5454
Type: Location
1610, Luther Lane, Campbell, Osceola County, Florida, 34746, United States
PARK RIDGE, IL 600681243
Phone: (847) 795-3147
Fax: (847) 823-9222
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040625000381 | I | Clinical Psychologist | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | 90 | 11 | $0 |
Insurance plans in this area (ZIP 60187)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nephrology, Internal Medicine | IL | |
| A N E S T H E S I O L O G Y | IL | |
| - | MN | |
| - | IL | |
| - | IL | |
| Rheumatology, Internal Medicine | IL | |
| - | IL | |
| Internal Medicine | IL | |
| P S Y C H I A T R Y | IL | |
| - | IL |
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