Individual
ELISE SCOGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4800 MAINE ST, QUINCY, IL 62305-5875
(217) 214-6250
(217) 214-5826
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-1200
(217) 277-3960
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036146947
IL
207N00000X
Dermatology Physician
OT015672
PA
207ND0101X
MOHS-Micrographic Surgery Physician
036146947
IL
Other
Enumeration date
05/21/2014
Last updated
03/31/2026
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