Provider Demographics
NPI:1265615512
Name:SCARLAS, JOHN (MS -CCCA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:SCARLAS
Suffix:
Gender:M
Credentials:MS -CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8123
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:10900 MANCHESTER RD STE 202
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-1200
Practice Address - Country:US
Practice Address - Phone:314-835-9996
Practice Address - Fax:314-835-9992
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001261237600000X
MO118419237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
06032213OtherBCBS-IL
MO143276OtherBCBS OF MO
MO000024835Medicare PIN