Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 135.001112 | IL |
NPI | 1063090702 |
---|---|
Provider Name | Nicolas Beci |
First Address | Oak Park, IL 60304-2807 |
Second Address | Oak Park, IL 60304-2807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2021 |
Last Update Date | 18/06/2021 |