Individual
STACEY SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1915 S ARCHER AVE, CHICAGO, IL 60616-1618
(312) 674-9132
(312) 674-9392
Mailing address
1915 S ARCHER AVE, CHICAGO, IL 60616-1618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Enumeration date
05/26/2006
Last updated
02/05/2008
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