Individual
MICHAEL JON BECKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
701 N 1ST ST, MEMORIAL MEDICAL CENTER, SPRINGFIELD, IL 62781
(217) 788-3064
(217) 788-5577
Mailing address
6450 RELIABLE PARKWAY, CHICAGO, IL 60686
(217) 788-3000
(217) 788-5577
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360959161
—
IL
Enumeration date
08/16/2006
Last updated
07/08/2007
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