MEDICARE: DR. SCOTT KAPLAN PH.D.

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	103TC0700X	Clinical Psychologist	071008091	IL
2	103TC0700X	Clinical Psychologist	1915	KS

General Provider Information

NPI Number	:	1174822019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT KAPLAN PH.D.

Provider Business Mailing Address
First Line	:	1503 FRANK AVE
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-3522
Country	:	US
Telephone Number	:	312-882-3344
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 N MICHIGAN AVE STE 1820
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3639
Country	:	US
Telephone Number	:	312-882-3344
Fax Number	:

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

Provider Enumeration Date	:	03/17/2011
Last Update Date	:	03/17/2011

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