Provider Demographics
NPI:1952072787
Name:AKOSAH, BECKY
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:AKOSAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:AKOSAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN RN
Mailing Address - Street 1:14432 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2508
Mailing Address - Country:US
Mailing Address - Phone:815-230-3549
Mailing Address - Fax:
Practice Address - Street 1:1314 ROWELL AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-2866
Practice Address - Country:US
Practice Address - Phone:815-725-5451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041430430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse