Provider Demographics
NPI:1851525810
Name:DAWN BECKMAN, M.D., S.C.
Entity Type:Organization
Organization Name:DAWN BECKMAN, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-307-0663
Mailing Address - Street 1:1 TIFFANY PT
Mailing Address - Street 2:SUITE G14
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2936
Mailing Address - Country:US
Mailing Address - Phone:630-307-0663
Mailing Address - Fax:630-307-0671
Practice Address - Street 1:1 TIFFANY PT
Practice Address - Street 2:SUITE G14
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2936
Practice Address - Country:US
Practice Address - Phone:630-307-0663
Practice Address - Fax:630-307-0671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-096750207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1851379200OtherINDIVIDUAL NPI
IL1851379200OtherINDIVIDUAL NPI