MEDICARE: SCOTT CHIROPRACTIC CLINICES, P.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
1	111N00000X	Chiropractor	038007163	IL

General Provider Information

NPI Number	:	1922269992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT CHIROPRACTIC CLINICES, P.C.

Provider Business Mailing Address
First Line	:	500 N MADISON ST
Second Line	:
City	:	MORRISON
State	:	IL
Zip	:	61270-2836
Country	:	US
Telephone Number	:	815-772-9000
Fax Number	:	815-772-9004

Provider Business Practice Location Address
First Line	:	500 N MADISON ST
Second Line	:
City	:	MORRISON
State	:	IL
Zip	:	61270-2836
Country	:	US
Telephone Number	:	815-772-9000
Fax Number	:	815-772-9004

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. REBECCA SUE SCOTT
Credential	:	D.C.
Telephone Number	:	815-772-9000

Provider Enumeration Date	:	06/22/2008
Last Update Date	:	07/22/2008

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