Healthcare Provider Details

I. General information

NPI: 1790894798
Provider Name (Legal Business Name): SCOTT E STROTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST SUITE 207
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

206 PRAIRIE VIEW DR
PALOS PARK IL
60464-2531
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-5340
  • Fax: 708-684-3355
Mailing address:
  • Phone: 708-684-5681
  • Fax: 708-684-4272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: