Provider Demographics
NPI:1760593701
Name:RITCHIE, SCOTT ALAN (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:RITCHIE
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 1/2 POLAND RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61834-7463
Mailing Address - Country:US
Mailing Address - Phone:217-446-5000
Mailing Address - Fax:217-446-6409
Practice Address - Street 1:3 1/2 POLAND RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61834-7463
Practice Address - Country:US
Practice Address - Phone:217-446-5000
Practice Address - Fax:217-446-6409
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL622220Medicare PIN
ILU82998Medicare UPIN