Provider Demographics
NPI:1922269992
Name:SCOTT CHIROPRACTIC CLINICES, P.C.
Entity Type:Organization
Organization Name:SCOTT CHIROPRACTIC CLINICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-772-9000
Mailing Address - Street 1:500 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:IL
Mailing Address - Zip Code:61270-2836
Mailing Address - Country:US
Mailing Address - Phone:815-772-9000
Mailing Address - Fax:815-772-9004
Practice Address - Street 1:500 N MADISON ST
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:IL
Practice Address - Zip Code:61270-2836
Practice Address - Country:US
Practice Address - Phone:815-772-9000
Practice Address - Fax:815-772-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty