Organization
ROBERT J BECKER MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN S BECKER M.D. (PRESIDENT)
(708) 354-5631
Entity
Organization
Contact information
Practice address
5201 WILLOW SPRINGS RD, LA GRANGE HIGHLANDS, IL 60525-6537
(708) 354-5631
(708) 482-0106
Mailing address
5201 WILLOW SPRINGS RD, LA GRANGE HIGHLANDS, IL 60525-6537
(708) 354-5631
(708) 482-0106
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036074851
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036066423
J. BECKER MD IL LICENSE #
IL
01
—
036074851
R BERTENSHAW IL LICENSE #
IL
01
—
1609994987
GROUP NPI
IL
01
—
1821014721
JONATHAN BECKER MD NPI#
IL
01
—
1992721898
RICHARD BERTENSHAW MD NPI
IL
01
—
21607143
GROUP BLUE CROSS ID #
IL
01
—
C30167
RAILROAD MEDICARE GROUP PTAN
IL
Enumeration date
03/26/2007
Last updated
08/13/2008
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