Individual
DR. MICHELLE SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7234 OGDEN AVE, RIVERSIDE, IL 60546-2269
(708) 447-1177
(708) 447-1286
Mailing address
PO BOX 7009, BOLINGBROOK, IL 60440-7009
(630) 312-7865
(630) 312-7902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36088149
IL
208M00000X
Hospitalist Physician
Primary
FO751W
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004227400
—
FL
01
—
1356386809
GROUP NPI
IL
01
—
1861420846
GROUP NPI
IL
01
—
400480
GROUP MEDICARE NUMBER
IL
01
—
CN4921
RR MEDICARE NUMBER
IL
01
—
DA1490
RR MEDICARE
IL
Enumeration date
05/06/2006
Last updated
04/20/2015
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