Physician Compare National (NPI:1790870038)

HEALTHCARE PROVIDER: DAVID ELLIS BEAUCHAMP D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1790870038
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3870677099
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080227000264
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEAUCHAMP
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Middle Name	ELLIS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NATIONAL COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	DIAGNOSTIC RADIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PHYSICAL MEDICINE AND REHABILITATION
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	DIAGNOSTIC RADIOLOGY, PHYSICAL MEDICINE AND REHABILITATION
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3706 E 23RD ST
	Group Practice or individual's line 1 address
City	STERLING
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	610814204
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M