Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | IL | |
N | 111NN1001X | Nutrition | IL |
NPI | 1326156522 |
---|---|
Provider Name | Dr. Scott M Stratton |
First Address | Frankfort, IL 60423 |
Second Address | Frankfort, IL 60423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001687572 | BCBS OF ILLINOIS (01) | IL |