MEDICARE: MICHELE ANN BECKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	041332336	IL

General Provider Information

NPI Number	:	1417579103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE ANN BECKER

Provider Business Mailing Address
First Line	:	2030 SEMINARY RD
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098
Country	:	US
Telephone Number	:	815-679-4628
Fax Number	:

Provider Business Practice Location Address
First Line	:	2030 SEMINARY RD
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-6009
Country	:	US
Telephone Number	:	815-679-4628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2020
Last Update Date	:	05/15/2020

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Directions to “ MICHELE ANN BECKER ” Practice Location

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