Organization
DEBORAH L. BEATY D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH L. BEATY DDS (DENTIST)
(312) 332-4424
Entity
Organization
Contact information
Practice address
111 N WABASH AVE STE 1921, CHICAGO, IL 60602-2970
(312) 332-4424
(312) 332-4423
Mailing address
111 N WABASH AVE, SUITE 1921, CHICAGO, IL 60602
(312) 332-4424
(312) 332-4423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
060006022
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060006022
PROFESSIONAL CORPORATION/DENTAL
IL
Enumeration date
05/02/2008
Last updated
05/02/2008
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