Provider Demographics
NPI:1588614879
Name:METRICK, SCOTT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:METRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1651 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1405
Mailing Address - Country:US
Mailing Address - Phone:847-482-0300
Mailing Address - Fax:847-482-9300
Practice Address - Street 1:900 N WESTMORELAND RD
Practice Address - Street 2:SUITE 220
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1674
Practice Address - Country:US
Practice Address - Phone:847-482-0300
Practice Address - Fax:847-482-9300
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2018-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360576872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC97977Medicare UPIN