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Individual

SCOTT ALLSUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1337 W EARLY AVE APT 1, CHICAGO, IL 60660-5465
(618) 670-0267
Mailing address
1337 W EARLY AVE APT 1, CHICAGO, IL 60660-5465

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
128348
IL

Other

Enumeration date
05/29/2020
Last updated
06/04/2024
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