Amy Beckman, MS, ATC, CSCS

Individual provider Active NPI Athletic Trainer · Macomb, IL

NPI 1730116591 · NPPES record last updated Nov 12, 2009

Key facts

NPI
1730116591
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
096.002864 (IL)
Practice address
1 University Circle
Western Illinois University Athletics
Macomb, IL 61455
Phone
(505) 925-5540
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
096.002864ILMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Athletic Trainer 2255A2300X 096.002864 IL Yes

Addresses

Primary practice location

1 University Circle
Western Illinois University Athletics
Macomb, IL 61455

Mailing address

170 S Yorktown Rd
Macomb, IL 61455-9404
Phone (774) 261-0590

Other providers in Macomb, IL

All providers in Macomb, IL · Athletic Trainer in Illinois

Sources for this page

Verify at the official NPI Registry.