Provider Demographics
NPI:1972527315
Name:GIRARD, SCOTT ANDREW (MD)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ANDREW
Last Name:GIRARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LEFEVRE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1278
Mailing Address - Country:US
Mailing Address - Phone:815-564-4502
Mailing Address - Fax:
Practice Address - Street 1:ONE KISH HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115
Practice Address - Country:US
Practice Address - Phone:630-936-4029
Practice Address - Fax:630-936-4032
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113580207L00000X
IL036.113580207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology