Provider Demographics
NPI:1356515597
Name:SCOTT, TIFFANY LYNN (MD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:LYNN
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3325 N. ARLINGTON HEIGHTS ROAD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004
Mailing Address - Country:US
Mailing Address - Phone:847-398-0400
Mailing Address - Fax:847-398-9590
Practice Address - Street 1:76 STIRLING RD.
Practice Address - Street 2:SUITE 201
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059
Practice Address - Country:US
Practice Address - Phone:908-755-5437
Practice Address - Fax:908-755-6905
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00207208000000X
IL36-134855208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics