MEDICARE: DR. CYNTHIA A. BECKER D.C.

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	111N00000X	Chiropractor	038006853	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	350030973	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5082025	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1295717403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA A. BECKER D.C.

Provider Business Mailing Address
First Line	:	1403 E MAIN ST
Second Line	:
City	:	MENDOTA
State	:	IL
Zip	:	61342-1077
Country	:	US
Telephone Number	:	815-538-2182
Fax Number	:	815-539-9163

Provider Business Practice Location Address
First Line	:	1403 E MAIN ST
Second Line	:
City	:	MENDOTA
State	:	IL
Zip	:	61342-1077
Country	:	US
Telephone Number	:	815-538-2182
Fax Number	:	815-539-9163

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	07/13/2016

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