Organization Active NPI

Scott J. Rusco D.O. Inc

  • Family Medicine Physician
  • Oak Forest, IL
National Provider Identifier
1497958029
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SCOTT J. RUSCO D.O. INC
Practice address
6360 159TH St
Suites D & E
Oak Forest, IL 60452-2725
Phone
(708) 535-6204
Fax
(708) 535-6431
NPI assigned
Jun 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott J Rusco, DONPI 1023050150
Title
Physician
Phone
(708) 535-6204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

6360 159TH St
Suites D & E
Oak Forest, IL 60452-2725

Mailing address

6360 159TH St
Suites D & E
Oak Forest, IL 60452-2725
Phone (708) 535-6204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071203000476 IL Part B Supplier - Clinic/Group Practice 2769571421 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Forest, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2163787Scott J Rusco, D O, Inc (Private Office)6360 W 159TH St - Ste D & E, Oak Forest, IL 60452Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1497958029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 159TH ST",
            "address_2": "SUITES D & E",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522725",
            "telephone_number": "708-535-6204",
            "fax_number": "708-535-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 159TH ST",
            "address_2": "SUITES D & E",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522725",
            "telephone_number": "708-535-6204",
            "fax_number": "708-535-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT J. RUSCO D.O. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-10",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "RUSCO",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-535-6204",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.