MEDICARE: DR. NASTANE LE BEC MD

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	208M00000X	Hospitalist Physician	036128617	IL
2	207QA0505X	Adult Medicine Physician	036128617	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	214881	OTHER	IL	MEDICARE GROUP PTAN

General Provider Information

NPI Number	:	1518123843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASTANE LE BEC MD

Provider Business Mailing Address
First Line	:	6225 S KENWOOD AVE APT 1S
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-3766
Country	:	US
Telephone Number	:	646-431-0013
Fax Number	:

Provider Business Practice Location Address
First Line	:	6225 S KENWOOD AVE APT 1S
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-3766
Country	:	US
Telephone Number	:	646-431-0013
Fax Number	:

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

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	11/30/2018

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