Provider Demographics
NPI:1629782602
Name:SCOTT, SASHA EILEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:EILEEN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:340 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3509
Mailing Address - Country:US
Mailing Address - Phone:773-966-0333
Mailing Address - Fax:773-435-6471
Practice Address - Street 1:340 E 51ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-3509
Practice Address - Country:US
Practice Address - Phone:773-966-0333
Practice Address - Fax:773-435-6471
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-10-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant