Individual
DR. MARY SUSAN SCANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1721 MOON LAKE BLVD STE 100, HOFFMAN ESTATES, IL 60169-5700
(847) 884-9700
Mailing address
2801 LAKESIDE DR STE 209, BANNOCKBURN, IL 60015-1271
(847) 562-1410
(847) 562-0830
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036093270
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623696
BCBS
—
05
—
036093270
—
IL
Enumeration date
10/06/2006
Last updated
01/20/2020
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