Individual
MR. SCOTT J OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
222 S RIVERSIDE PLZ STE 830, CHICAGO, IL 60606-5900
(312) 416-3804
(312) 627-2700
Mailing address
14342 S BOULDER DR, HOMER GLEN, IL 60491-7571
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
IL
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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