Healthcare Provider Details

I. General information

NPI: 1639287147
Provider Name (Legal Business Name): SCOTT H HERMAN DDS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 E OAK KNOLL DR
HAMPSHIRE IL
60140-9095
US

IV. Provider business mailing address

179 E OAK KNOLL DR
HAMPSHIRE IL
60140-9095
US

V. Phone/Fax

Practice location:
  • Phone: 847-683-3464
  • Fax: 847-683-5209
Mailing address:
  • Phone: 847-683-3464
  • Fax: 847-683-5209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. SCOTT H HERMAN
Title or Position: OWNER
Credential: DDS
Phone: 847-683-3464