Provider Demographics
NPI:1932800794
Name:MCLAUGHLIN, SCOTT DILLON
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:DILLON
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2708
Mailing Address - Country:US
Mailing Address - Phone:630-802-9583
Mailing Address - Fax:
Practice Address - Street 1:1775 BALLARD RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1005
Practice Address - Country:US
Practice Address - Phone:847-318-9340
Practice Address - Fax:847-318-2966
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2024-04-12
Deactivation Date:2024-03-31
Deactivation Code:
Reactivation Date:2024-04-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program