=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851525810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAWN BECKMAN, M.D., S.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2009
-----------------------------------------------------
Last Update Date | 06/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 TIFFANY PT SUITE G14
-----------------------------------------------------
City | BLOOMINGDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60108-2936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-307-0663
-----------------------------------------------------
Fax | 630-307-0671
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 TIFFANY PT SUITE G14
-----------------------------------------------------
City | BLOOMINGDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60108-2936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-307-0663
-----------------------------------------------------
Fax | 630-307-0671
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | M.D./PRESIDENT
-----------------------------------------------------
Name | DR. DAWN BECKMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 630-307-0663
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 036-096750
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------