Healthcare Provider Details

I. General information

NPI: 1770923559
Provider Name (Legal Business Name): EMILY MICHELLE BECK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20646 ABBEY WOODS CT N STE 104
FRANKFORT IL
60423-3170
US

IV. Provider business mailing address

3265 NE RALPH POWELL RD
LEES SUMMIT MO
64064-2301
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-8554
  • Fax: 630-495-1770
Mailing address:
  • Phone: 816-454-3424
  • Fax: 913-663-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036147755
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2026028258
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: