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Individual

SCOTT JAMES MAHON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
125062715
IL
2085R0202X
Diagnostic Radiology Physician
Primary
DO191292
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085002811
LICENSE
IL
01
P00465572
MEDICARE RAILROAD/PALMETTO GBA
IL
Enumeration date
09/29/2006
Last updated
11/02/2020
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