MEDICARE: SCOTT W SIEGNER M.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	174400000X	Specialist	036102707	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2201714	OTHER	IL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386684066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT W SIEGNER M.D.

Provider Business Mailing Address
First Line	:	7808 W COLLEGE DR STE 3SW
Second Line	:	CHICAGOLAND RETINAL CONSULTANTS
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1027
Country	:	US
Telephone Number	:	708-671-1009
Fax Number	:	708-671-1109

Provider Business Practice Location Address
First Line	:	7808 W COLLEGE DR
Second Line	:	SUITE 3 SW
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1027
Country	:	US
Telephone Number	:	708-671-1009
Fax Number	:	708-671-1109

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	12/09/2021

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Directions to “ SCOTT W SIEGNER M.D.” Practice Location

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