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General NPI Number Information
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NPI Number | 1689357162
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Entity Type | Individual
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Provider Name | CHRISTIAN HENRY BECKER PTA
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Gender | Male
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 170 JAMESTOWN LN
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-2119
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Country | US
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Telephone | 224-543-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 W TOUHY AVENUE UNIT #316
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 224-402-1815
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160.009488
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License Number State | IL
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