Provider Demographics
NPI:1295812964
Name:SCOTT M MORCOTT, MD SC
Entity type:Organization
Organization Name:SCOTT M MORCOTT, MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-816-8686
Mailing Address - Street 1:250 CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1582
Mailing Address - Country:US
Mailing Address - Phone:847-816-8686
Mailing Address - Fax:847-816-8898
Practice Address - Street 1:250 CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1582
Practice Address - Country:US
Practice Address - Phone:847-816-8686
Practice Address - Fax:847-816-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1386638708OtherNPI
IL214333Medicare PIN
ILG92349Medicare UPIN
ILIL6290Medicare PIN