Individual
SCOTT LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
917 SHERWOOD DR STE 200, LAKE BLUFF, IL 60044-2234
(847) 232-3447
(224) 678-0001
Mailing address
917 SHERWOOD DR STE 200, LAKE BLUFF, IL 60044-2234
(847) 232-3447
(224) 678-0001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036075026
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036075026
STATE LICENSE
IL
05
—
036075026
—
IL
Enumeration date
01/17/2007
Last updated
06/11/2024
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