Individual
MICHAEL E BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD SC
Contact information
Practice address
4938 W 95TH ST, OAK LAWN, IL 60453-2504
(708) 425-4662
Mailing address
4938 W 95TH ST, OAK LAWN, IL 60453-2504
(708) 425-4662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
03610897
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635476
BLUE CROSS BLUE SHIELD
IL
05
—
036108097
—
IL
Enumeration date
02/01/2007
Last updated
10/27/2010
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