DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SCOTT DETLOFF PA-C

MEDICARE: SCOTT DETLOFF PA-C
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
1363A00000XPhysician Assistant085006832IL
2363AS0400XSurgical Physician Assistant085-006832IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1085006832OTHERILSTATE LICENSE

General Provider Information

NPI Number : 1639651060
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT DETLOFF PA-C
Provider Business Mailing Address
First Line : 2000 LAKE AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-7401
Country : US
Telephone Number : 815-337-7100
Fax Number : 815-337-4793
Provider Business Practice Location Address
First Line : 2000 LAKE AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-7401
Country : US
Telephone Number : 815-337-7100
Fax Number : 815-337-4793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2018
Last Update Date : 03/20/2026

Similar Medicare Providers

1750389953 — ANIL K KHEMANI MD
Practice Location Address:
2000 LAKE AVE
WOODSTOCK, IL
60098-7401
Practice Phone: 815-337-7100
Practice Fax: 815-337-4700
1831166958 — JEFFREY S ALTMAN MD
Practice Location Address:
2000 LAKE AVE
WOODSTOCK, IL
60098-7401
Practice Phone: 815-337-7100
Practice Fax: 815-337-4793
1336193507 — GILBERT J CUA PT
Practice Location Address:
2000 LAKE AVE
WOODSTOCK, IL
60098-7401
Practice Phone: 815-337-7100
Practice Fax: 815-337-4793
1992751002 — PAULA FRENCH PT
Practice Location Address:
2000 LAKE AVE
WOODSTOCK, IL
60098-7401
Practice Phone: 815-337-7100
Practice Fax:
1053368506 — LISA A ELIAS PT
Practice Location Address:
2000 LAKE AVE
WOODSTOCK, IL
60098-7401
Practice Phone: 815-337-7100
Practice Fax:
1437196698 — AMY MARIE MICHALAK OT
Practice Location Address:
2000 LAKE AVE
WOODSTOCK, IL
60098-7401
Practice Phone: 815-337-7100
Practice Fax:

Directions to “ SCOTT DETLOFF PA-C” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.