| Scott Detloff, PA-C | |
|
2000 Lake Ave, Woodstock, IL 60098-7401 | |
| (815) 337-7100 | |
| (815) 337-4793 |
| Full Name | Scott Detloff |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 8 Years |
| Location | 2000 Lake Ave, Woodstock, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639651060 | NPI | - | NPPES |
| 085006832 | Other | IL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085006832 (Illinois) | Primary |
| 363AS0400X | Physician Assistant - Surgical | 085-006832 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercyhealth Hospital & Physician Clinic-crystal La | Crystal lake, IL | Hospital |
| Mercy Harvard Hospital | Harvard, IL | Hospital |
| Northwestern Medicine Mchenry Hospital | Mchenry, IL | Hospital |
| Northwest Community Hospital 1 | Arlington heights, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Endeavor Health Medical Group | 2163334699 | 3330 |
| Mercy Health System Corporation | 7416860440 | 749 |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031111000307 |
| Entity Name | Endeavor Health Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
| Entity Name | Mercy Harvard Hospital Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1427001445 PECOS PAC ID: 6204729577 Enrollment ID: O20081103000092 |
| Entity Name | Northwest Community Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134433154 PECOS PAC ID: 3375737331 Enrollment ID: O20101103000837 |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Detloff, PA-C 2000 Lake Ave, Woodstock, IL 60098-7401 Ph: (815) 337-7100 | Scott Detloff, PA-C 2000 Lake Ave, Woodstock, IL 60098-7401 Ph: (815) 337-7100 |
Christine R Watson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2000 Lake Ave, Woodstock, IL 60098 Phone: 815-337-7100 Fax: 815-337-4790 |
Lauren Ashley Thompson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4402 Greenwood Rd, Woodstock, IL 60098 Phone: 262-903-0187 |
Denise Arlen Mcnatt, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10413 Saddlebred Trl, Woodstock, IL 60098 Phone: 206-669-4070 |
Jenna M Raju, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2000 Lake Ave, Woodstock, IL 60098 Phone: 815-337-7100 Fax: 815-337-4793 |