Provider Demographics
NPI:1346387164
Name:MCDOWELL, ROGER SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:SCOTT
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-0280
Mailing Address - Country:US
Mailing Address - Phone:630-430-8372
Mailing Address - Fax:
Practice Address - Street 1:345 W OGDEN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1419
Practice Address - Country:US
Practice Address - Phone:630-430-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2223248OtherBLUE CROSS OF IL
IL539650Medicare ID - Type Unspecified
IL2223248OtherBLUE CROSS OF IL