Individual
DR. MICHAEL D SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5404 FAIRVIEW AVE, DOWNERS GROVE, IL 60515-5332
(630) 921-1606
Mailing address
5404 FAIRVIEW AVE, DOWNERS GROVE, IL 60515-5332
(630) 921-1606
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036100296
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100296
—
IL
05
—
036100296-4
—
IL
01
—
3932056
BLUE SHIELD
IL
Enumeration date
01/03/2006
Last updated
05/13/2009
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