person
Scott Detloff, PA-C
Surgical Physician Assistant in Woodstock, Illinois
NPI 1639651060

Scott Detloff is a Surgical Physician Assistant based in Woodstock, IL and is specialized in Surgical. Scott Detloff practices in Woodstock, IL and has the professional credentials of PA-C. The NPI Number for Scott Detloff is 1639651060 and holds a License No. 085-006832 (Illinois).

The current practice location address for Scott Detloff is 2000 Lake Ave, Woodstock, IL and can be reached out via phone at 815-337-7100 and via fax at 815-337-4793.

Location: 2000 Lake Ave, Woodstock, IL, 60098-7401
person
Provider Profile Details
NPI Number
1639651060
Provider Name
Scott Detloff
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
2000 Lake Ave, Woodstock, IL, 60098-7401
Phone Number
815-337-7100
Fax Number
815-337-4793
Provider Enumeration Date
09/01/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
085006832 01 IL STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
2000 Lake Ave
City
State
Zip
60098-7401
Phone Number
815-337-7100
Fax Number
815-337-4793
person
Provider Business Mailing Address Details
Address
2000 Lake Ave
City
State
Zip
60098-7401
Phone Number
815-337-7100
Fax Number
815-337-4793
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
085-006832 (Illinois)
Definition
Definition to come...
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