Provider Demographics
NPI:1518172576
Name:BECKER, WILLIAM JOHN
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:BECKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 E WAVERLY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2639
Mailing Address - Country:US
Mailing Address - Phone:847-394-8961
Mailing Address - Fax:847-394-5497
Practice Address - Street 1:2630 NEW SUTTON RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192
Practice Address - Country:US
Practice Address - Phone:847-884-8484
Practice Address - Fax:847-884-8486
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-12876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist