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Individual

DR. SCOTT JASON SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
205 W RANDOLPH ST, 1205, CHICAGO, IL 60606-1867
(312) 265-6908
(312) 264-0347
Mailing address
205 W RANDOLPH ST, 1205, CHICAGO, IL 60606-1867
(312) 265-6908
(312) 264-0347

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
038009369
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01629928
BLUE CROSS BLUE SHIELD
IL
01
7626403
AETNA
IL
Enumeration date
01/04/2007
Last updated
04/04/2013
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