Scott J. Rusco D.o. Inc | |
6360 159th St Suites D & E Oak Forest IL 60452-2725 | |
(708) 535-6204 | |
(708) 535-6431 |
Full Name | Scott J. Rusco D.o. Inc |
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Speciality | Family Medicine |
Location | 6360 159th St, Oak Forest, Illinois |
Authorized Official Name and Position | Scott J Rusco (PHYSICIAN) |
Authorized Official Contact | 7085356204 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Scott J. Rusco D.o. Inc 6360 159th St Suites D & E Oak Forest IL 60452-2725 Ph: (708) 535-6204 | Scott J. Rusco D.o. Inc 6360 159th St Suites D & E Oak Forest IL 60452-2725 Ph: (708) 535-6204 |
NPI Number | 1497958029 |
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Provider Enumeration Date | 06/10/2007 |
Last Update Date | 12/14/2007 |
Medicare PECOS PAC ID | 2769571421 |
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Medicare Enrollment ID | O20071203000476 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497958029 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Illinois) | Primary |
Provider Name | Scott J Rusco |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023050150 PECOS PAC ID: 6204882756 Enrollment ID: I20050328000700 |
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