Most Relevant Information
Provider Data
| NPI Number: | 1003417809 |
| Provider Name: | SCOTT BEVANS |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 051299782 |
Most Important Dates
| Enumeration Date: | 11/06/2020 |
| Last Updated: | 11/06/2020 |
Provider Practice Location
16241 S FARRELL RD
LOCKPORT
IL
604418101
Practice Location Phone/Fax
| Phone: | 8158363422 |
| Fax: |
Provider Mailing Location
305 S HAMMES AVE
JOLIET
IL
604361107
Provider Mailing Phone/Fax
| Phone: | 7088228144 |
| Fax: |