Individual
ANTHONY J SCARDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
180 SOUTH MAIN STREET, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 SOUTH MAIN STREET, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
08500268
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021651
HEALTH ALLIANCE
IL
05
—
0850002698
—
IL
01
—
4281670001
DME
IL
01
—
7230175
BLUE CROSS BLUE SHIELD
IL
01
—
970019987
RR MEDICARE
IL
01
—
IL0102
JOHN DEERE
IL
Enumeration date
05/20/2006
Last updated
04/13/2021
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