# DR. DAVID M BEATTY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568471274
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036112014 | IL | Yes |
| 207Q00000X | Family Medicine Physician | 38680 | WI | — |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 12/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 020057300 | BLACK LUNG | IL |
| 01 | — | 036112014 | STATE LICENSE | IL |
| 01 | — | 08421024 | BCBS | IL |
| 01 | — | 130434 | HEALTH ALLIANCE | IL |
| 01 | — | 133586700 | ACS-OWCP | IL |
| 01 | — | 14D0435365 | CLIA CERT CHATHAM LOC | IL |
| 01 | — | 14D0949277 | CLIA CERT SPFLD LOC | IL |
| 01 | — | 310046 | PERSONAL CARE | IL |
| 01 | — | 6394P | CATERPILLAR | IL |
| 01 | — | 787412 | HEALTHLINK | IL |
| 01 | — | CD7143 | RR MEDICARE GROUP | IL |
| 01 | — | P00397731 | RR MEDICARE IND PROV ID | IL |