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General NPI Number Information
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NPI Number | 1992704381
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Entity Type | Individual
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Provider Name | JAMES EDWARD BECKETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 326 W 64TH ST ST BERNARD HOSPITAL DEPT RADIOLOGY
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City | CHICAGO
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State | IL
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Zip | 60621-3114
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Country | US
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Telephone | 773-962-4030
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Fax | 773-962-4399
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Provider Business Mailing Address
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Address Line | 2 CARRINGTON CT
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City | HAZEL CREST
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State | IL
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Zip | 60429-2517
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Country | US
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Telephone | 708-341-6707
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Fax | 708-298-5723
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 036-087374
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 36-087374
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 36-087374
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 36-087374
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License Number State | IL
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