Becker, Jason E.

Becker, Jason E. is an individual health care provider with primary practice located at 2900 N Knoxville Ave , Peoria IL 61603-1748. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Becker, Jason E. can be contacted via phone (309) 688-3616.

Contact Information

Primary practice address
2900 N Knoxville Ave Peoria IL 61603-1748
Phone: (309) 688-3616
Fax: (309) 687-3370
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036118738 Illinois

Profile Details

NPI number 1922215920
LBN Legal business name Becker, Jason E.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Sep 10th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922215920 NPPES
Illinois MEDICAID 036118738

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