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General NPI Number Information
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NPI Number | 1922269992
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Entity Type | Organization
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Legal Business Name | SCOTT CHIROPRACTIC CLINICES, P.C.
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Dates
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Enumeration Date | 06/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 500 N MADISON ST
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City | MORRISON
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State | IL
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Zip | 61270-2836
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Country | US
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Telephone | 815-772-9000
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Fax | 815-772-9004
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Provider Business Mailing Address
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Address Line | 500 N MADISON ST
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City | MORRISON
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State | IL
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Zip | 61270-2836
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Country | US
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Telephone | 815-772-9000
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Fax | 815-772-9004
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. REBECCA SUE SCOTT
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Credential | D.C.
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Telephone | 815-772-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038007163
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License Number State | IL
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