Provider Demographics
NPI:1396472247
Name:BECK, BETH ANN (APRN CWOCN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:BECK
Suffix:
Gender:F
Credentials:APRN CWOCN
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN CWOCN
Mailing Address - Street 1:1406 BURGER AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-8505
Mailing Address - Country:US
Mailing Address - Phone:815-347-2812
Mailing Address - Fax:
Practice Address - Street 1:1201 EAGLE ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2031
Practice Address - Country:US
Practice Address - Phone:815-740-8100
Practice Address - Fax:815-740-8102
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.016777163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.016777OtherAPRN LICENSE NUMBER