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Individual

DR. TONI SCOTT-TERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
20201 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461-1010
(708) 679-2160
Mailing address
430 E 162ND ST, #300, SOUTH HOLLAND, IL 60473-2258
(708) 566-4856
(708) 782-2045

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
01068507A
IN
207V00000X
Obstetrics & Gynecology Physician
01068507A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
036102112
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036102112
IL
05
300066566
IN
01
F400214350
MEDICARE PTAN
IL
01
M71485205
MEDICARE PTAN
IN
Enumeration date
08/16/2006
Last updated
09/21/2022
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