Organization
DRS BEAMER CARLON CRAIGEN SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY K BEAMER MD (SECRETARY)
(708) 628-0600
Entity
Organization
Contact information
Practice address
1011 LAKE ST, SUITE 300, OAK PARK, IL 60301-1148
(708) 628-0600
(708) 628-0608
Mailing address
1011 W LAKE ST, SUITE 300, OAK PARK, IL 60301-1148
(708) 628-0600
(708) 628-0608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
207R00000X
Internal Medicine Physician
—
IL
208000000X
Pediatrics Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634566
BCBS PROVIDER ID
IL
01
—
DC8910
RAILROAD MEDICARE
IL
Enumeration date
06/20/2006
Last updated
01/09/2008
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