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NPI Code Detail

MEDICARE: LYNN M SCARBROUGH NP

MEDICARE:   LYNN M SCARBROUGH  NP
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
1363L00000XNurse Practitioner209-001285IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1458110OTHERILPIN # FOR NORTHWEST COMM.

General Provider Information

NPI Number : 1720018351
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN M SCARBROUGH NP
Provider Business Mailing Address
First Line : 120 N NORTHWEST HWY
Second Line :
City : BARRINGTON
State : IL
Zip : 60010-3347
Country : US
Telephone Number : 847-382-6579
Fax Number :
Provider Business Practice Location Address
First Line : 120 N NORTHWEST HWY
Second Line :
City : BARRINGTON
State : IL
Zip : 60010-3347
Country : US
Telephone Number : 847-382-6579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 01/24/2012

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