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NPI Code Detail

MEDICARE: SCOTT SACKETT DO

MEDICARE: SCOTT SACKETT 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1508678335
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT SACKETT DO
Provider Business Mailing Address
First Line : 18109 IVY LN
Second Line :
City : OLNEY
State : MD
Zip : 20832-2009
Country : US
Telephone Number : 301-789-4936
Fax Number :
Provider Business Practice Location Address
First Line : 555 31ST ST
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-1235
Country : US
Telephone Number : 800-458-6253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2025
Last Update Date : 05/27/2026

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Directions to “ SCOTT SACKETT DO” Practice Location

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