Individual
SCOTT CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 SAINT CLARE CT, WASHINGTON, IL 61571-9239
(309) 886-4003
(309) 886-4116
Mailing address
10 SAINT CLARE CT, WASHINGTON, IL 61571-9239
(309) 886-4003
(309) 886-4116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-076809
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076809
—
IL
Enumeration date
10/20/2006
Last updated
04/12/2010
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