MEDICARE: SCOTT R LOWRY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036062578	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184626673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT R LOWRY DO

Provider Business Mailing Address
First Line	:	74 GRAYMOOR LN
Second Line	:
City	:	OLYMPIA FIELDS
State	:	IL
Zip	:	60461-1216
Country	:	US
Telephone Number	:	708-417-3375
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 171ST ST STE Q
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60487
Country	:	US
Telephone Number	:	708-966-0788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	03/29/2024

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Directions to “ SCOTT R LOWRY DO” Practice Location

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