Individual
KEVIN M BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007392
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007392
—
IL
Enumeration date
02/13/2006
Last updated
11/14/2008
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