Provider Demographics
NPI:1548045826
Name:DOYLE, SCORPIA (FNP)
Entity type:Individual
Prefix:
First Name:SCORPIA
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9308 S SOUTH CHICAGO AVE UNIT 17058
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-0503
Mailing Address - Country:US
Mailing Address - Phone:773-619-6017
Mailing Address - Fax:
Practice Address - Street 1:10640 165TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8734
Practice Address - Country:US
Practice Address - Phone:312-316-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty