Individual
BECKY S LEBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3131 N WATER ST, DECATUR, IL 62526-2472
(217) 876-5320
(217) 876-5865
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-7550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209022455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.304402
RN LICENSE
IL
Enumeration date
12/16/2020
Last updated
12/16/2020
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