Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | IL |
NPI | 1700835907 |
---|---|
Provider Name | Dr. Carlos Bekerman |
First Address | Chicago, IL 60616-2333 |
Second Address | Chicago, IL 60616-2333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 10/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BB6340602 | DEA (01) | IL |
C42175 | (02) | IL |