Provider Demographics
NPI:1760792352
Name:MCDANIEL, SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 HIGH GROVE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7628
Mailing Address - Country:US
Mailing Address - Phone:630-371-9980
Mailing Address - Fax:630-371-1555
Practice Address - Street 1:7055 HIGH GROVE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7628
Practice Address - Country:US
Practice Address - Phone:630-371-9980
Practice Address - Fax:630-371-1555
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132364207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine