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General NPI Number Information
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NPI Number | 1457354656
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Entity Type | Individual
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Provider Name | FREDERICK G. BEHM MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 840 S WOOD ST DEPARTMENT OF PATHOLOGY, MC847
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City | CHICAGO
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State | IL
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Zip | 60612-4325
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Country | US
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Telephone | 312-996-3150
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Fax | 312-413-0156
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Provider Business Mailing Address
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Address Line | 840 S WOOD ST DEPARTMENT OF PATHOLOGY, MC847
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City | CHICAGO
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State | IL
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Zip | 60612-4325
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Country | US
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Telephone | 312-996-3150
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Fax | 312-413-0156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 16605
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036-116729
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License Number State | IL
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