Look up the most recent NPI and PECOS records

William Scurlock

Family Medicine

Allopathic & Osteopathic Physicians

110 S 17th St, St Charles, IL 60174-2526

PECOS Enrollment

Based on the most recent information from CMS, provider William Scurlock is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1699726505
Provider Type
Individual
Full Name
Scurlock, William
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/15/2006
Last Updated
3/29/2018

Contact Information

Practice Location

110 S 17th St, St Charles, IL 60174-2526

(630) 377-2800

(630) 377-6774

Mailing Location

1860 Paysphere Cir, Chicago, IL 60674-0018

(630) 469-9200

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 036061339 Illinois

Provider Identifiers

ID	Description	Issuer
ID 036061339	Description Medicaid	Issuer Unlisted Illinois

William Scurlock

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Kenneth J Liesen Md Sc

Heiger, Ariana

Ward, Edward J

Thakkar, Jayesh

Calabria, Robert J

Kruse, Daniel J

Chintam, Lalithasree

Long, Robert Wayne

Thakkar, Hemalini

Fifth Ave Primary Care Physicians Sc