Provider Demographics
NPI:1881877694
Name:CHARLES A BECK JR MD LTD
Entity type:Organization
Organization Name:CHARLES A BECK JR MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-957-2993
Mailing Address - Street 1:71 W 156TH ST
Mailing Address - Street 2:STE 210
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-4260
Mailing Address - Country:US
Mailing Address - Phone:708-596-2034
Mailing Address - Fax:708-596-1119
Practice Address - Street 1:71 W 156TH ST
Practice Address - Street 2:STE 210
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-4260
Practice Address - Country:US
Practice Address - Phone:708-596-2034
Practice Address - Fax:708-596-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13026Medicare UPIN
IL488670Medicare PIN