Basic Information
Provider Information
NPI: 1285632232
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRICE
FirstName: SCOTT
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7600 W COLLEGE DR
Address2:  
City: PALOS HEIGHTS
State: IL
PostalCode: 604631001
CountryCode: US
TelephoneNumber: 7083610600
FaxNumber: 7089232529
Practice Location
Address1: 7600 W COLLEGE DR
Address2:  
City: PALOS HEIGHTS
State: IL
PostalCode: 604631001
CountryCode: US
TelephoneNumber: 7083610600
FaxNumber: 7089232529
Other Information
ProviderEnumerationDate: 07/13/2005
LastUpdateDate: 12/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X036073372ILY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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