Healthcare Provider Details

I. General information

NPI: 1821259490
Provider Name (Legal Business Name): ERIC H BECK DO, EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 05/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE # MC5068 UNIVERSITY OF CHICAGO MEDICAL CENTER
CHICAGO IL
60637-1447
US

IV. Provider business mailing address

5841 S MARYLAND AVE # MC5068 UNIVERSITY OF CHICAGO MEDICAL CENTER
CHICAGO IL
60637-1447
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-9500
  • Fax:
Mailing address:
  • Phone: 773-702-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOT012475
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number101871
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125055762
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02003669A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: