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NPI Code Detail

MEDICARE: LUCAS BELTRAN

MEDICARE:   LUCAS  BELTRAN
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
1225100000XPhysical Therapist070-0244770IL

General Provider Information

NPI Number : 1922887736
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCAS BELTRAN
Provider Business Mailing Address
First Line : 900 RAND RD STE 300
Second Line :
City : DES PLAINES
State : IL
Zip : 60016-2359
Country : US
Telephone Number : 847-324-3976
Fax Number : 847-929-1154
Provider Business Practice Location Address
First Line : 19558 S HARLEM AVE STE 4
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-6743
Country : US
Telephone Number : 815-806-0019
Fax Number : 779-254-2927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2023
Last Update Date : 09/22/2023

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Directions to “ LUCAS BELTRAN ” Practice Location

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