Provider Demographics
NPI:1750308516
Name:SCOTT NEWCOMB, DPM PC
Entity type:Organization
Organization Name:SCOTT NEWCOMB, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEWCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-697-4500
Mailing Address - Street 1:431 SUMMIT ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3861
Mailing Address - Country:US
Mailing Address - Phone:847-697-4500
Mailing Address - Fax:847-697-0446
Practice Address - Street 1:431 SUMMIT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-3861
Practice Address - Country:US
Practice Address - Phone:847-697-4500
Practice Address - Fax:847-697-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210185Medicare ID - Type Unspecified
ILU91229Medicare UPIN
IL5592610001Medicare NSC