NPI Code Details Logo

NPI 1841262086

NPI 1841262086 : M. HYTHAM BECK M.D. : WATSEKA, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1841262086
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    M. HYTHAM BECK M.D.
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/02/2006
-----------------------------------------------------
    Last Update Date     |    10/04/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    200 E FAIRMAN AVE 
-----------------------------------------------------
    City                 |    WATSEKA
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60970-1644
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    815-432-5411
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    200E FAIRMAN AVE 
-----------------------------------------------------
    City                 |    WATSEKA
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60970-1644
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    815-432-5841
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207PE0005X
-----------------------------------------------------
    Taxonomy Name        |    Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
-----------------------------------------------------
    License Number       |    036068405
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    208600000X
-----------------------------------------------------
    Taxonomy Name        |    Surgery Physician
-----------------------------------------------------
    License Number       |    01062551A
-----------------------------------------------------
    License Number State |    IN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    208D00000X
-----------------------------------------------------
    Taxonomy Name        |    General Practice Physician
-----------------------------------------------------
    License Number       |    036068405
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    208600000X
-----------------------------------------------------
    Taxonomy Name        |    Surgery Physician
-----------------------------------------------------
    License Number       |    036068405
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.