Provider Demographics
NPI:1386638708
Name:MORCOTT, SCOTT MACKAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MACKAY
Last Name:MORCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E SCRANTON AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2561
Mailing Address - Country:US
Mailing Address - Phone:847-757-8686
Mailing Address - Fax:847-686-7284
Practice Address - Street 1:10 E SCRANTON AVE STE 303
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2561
Practice Address - Country:US
Practice Address - Phone:847-816-3434
Practice Address - Fax:847-686-7284
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-099609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL542580Medicare ID - Type Unspecified
ILG92349Medicare UPIN