Organization
JOAN SOPHIE & DEBORAH SCOTT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH SCOTT PHD (PARTNER)
(773) 472-7646
Entity
Organization
Contact information
Practice address
3047 N LINCOLN AVE, SUITE 400, CHICAGO, IL 60657-4999
(773) 472-7646
Mailing address
3047 N LINCOLN AVE, SUITE 400, CHICAGO, IL 60657-4999
(773) 472-7646
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619507
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/01/2006
Last updated
08/22/2020
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