MEDICARE: DR. STEPHEN PHILIP BECKER M.D,

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	036041732	IL

General Provider Information

NPI Number	:	1831184001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN PHILIP BECKER M.D,

Provider Business Mailing Address
First Line	:	233 E ERIE ST
Second Line	:	804
City	:	CHICAGO
State	:	IL
Zip	:	60611-2926
Country	:	US
Telephone Number	:	312-944-3627
Fax Number	:	312-944-6420

Provider Business Practice Location Address
First Line	:	233 E ERIE ST
Second Line	:	804
City	:	CHICAGO
State	:	IL
Zip	:	60611-2926
Country	:	US
Telephone Number	:	312-944-3627
Fax Number	:	312-944-6420

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	08/21/2013

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