Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mike S Davenport, FNP

Individual provider Family Nurse Practitioner · NPI 1295789576

Mike S Davenport, FNP is a Nurse Practitioner in Mc Leansboro, Illinois. Qualified in 1999, 27 years ago. Practices with Eldorado Emergency Group PC, a 14-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
27
Licensed in
IL
In the registry since
2006
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

206 S Washington St
Mc Leansboro, IL 62859-1139
Phone: (618) 643-2835
Fax: (618) 643-2891
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209.005569 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209.005569 (IL)

Record details

NPI number1295789576
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedMay 20, 2006
Last updated in NPPESApril 22, 2022
Certification dateApril 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Eldorado Emergency Group Pc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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