MEDICARE: BRANDI BECK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.026942	IL

General Provider Information

NPI Number	:	1083576763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI BECK

Provider Business Mailing Address
First Line	:	7164 CINDY DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61109-4808
Country	:	US
Telephone Number	:	815-289-1321
Fax Number	:

Provider Business Practice Location Address
First Line	:	7164 CINDY DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61109-4808
Country	:	US
Telephone Number	:	815-289-1321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ BRANDI BECK ” Practice Location

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