Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 036041732 | IL |
NPI | 1831184001 |
---|---|
Provider Name | Dr. Stephen Philip Becker |
First Address | Chicago, IL 60611-2926 |
Second Address | Chicago, IL 60611-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 21/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C43191 | (02) | IL |