Scott Payne
Individual provider Active NPI Social Worker · La Salle, IL
NPI 1245952191 · NPPES record last updated Sep 16, 2022
Key facts
- NPI
- 1245952191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 26677 (IL)
- Practice address
- 111 Bucklin St Ste 1
La Salle, IL 61301-2382 - Phone
- (815) 780-0690
- NPI assigned
- Sep 16, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26677 | IL | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 26677 | IL | Yes |
Addresses
Primary practice location
111 Bucklin St Ste 1
La Salle, IL 61301-2382
Mailing address
819 N 2803Rd Rd
Utica, IL 61373-9748
Phone (815) 228-3549
Other providers in La Salle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.