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Organization
GOLD COAST OSTEOPATHIC, PSC
Active
Organization
GOLD COAST OSTEOPATHIC, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AIDA BECKERLY (PRESIDENT)
(773) 554-6055
Entity
Organization
Contact information
Practice address
680 N LAKE SHORE DR STE 1040, CHICAGO, IL 60611-8718
(773) 554-6055
Mailing address
680 N LAKE SHORE DR, SUITE 1040, CHICAGO, IL 60611-4546
(773) 554-6055
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
NULL
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
07/01/2016
Last updated
09/13/2016
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