Individual
JASON E. BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 N KNOXVILLE AVE, PEORIA, IL 61603-1748
(309) 688-3616
(309) 687-3370
Mailing address
2900 N KNOXVILLE AVE, PEORIA, IL 61603-1748
(309) 688-3616
(309) 687-3370
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036118738
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118738
—
IL
Enumeration date
05/17/2007
Last updated
09/10/2007
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