Healthcare Provider Details

I. General information

NPI: 1326022161
Provider Name (Legal Business Name): BECK A HUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WESTMORELAND RD
LAKE FOREST IL
60045-1658
US

IV. Provider business mailing address

1000 N WESTMORELAND RD
LAKE FOREST IL
60045-1658
US

V. Phone/Fax

Practice location:
  • Phone: 847-234-5600
  • Fax: 847-535-7847
Mailing address:
  • Phone: 847-234-5600
  • Fax: 847-535-7847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036099063
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: