Organization
BEACON THERAPEUTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL WASHINGTON (CFO)
(773) 298-1243
Entity
Organization
Contact information
Practice address
1912 W 103RD ST, CHICAGO, IL 60643-2625
(773) 298-1243
(773) 298-1078
Mailing address
1912 W 103RD ST, CHICAGO, IL 60643-2625
(773) 298-1243
(773) 298-1078
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
02/09/2007
Last updated
08/22/2020
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