Individual
JOHN BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2499
(217) 528-7541
Mailing address
2040 W ILES AVE, SUITE C, SPRINGFIELD, IL 62704-4183
(217) 789-0668
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036103983
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103983
—
IL
05
—
209329101
—
MO
Enumeration date
06/09/2006
Last updated
08/22/2022
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