Most Relevant Information
Provider Data
| NPI Number: | 1003823188 |
| Provider Name: | SHONNA COTTON BECKMAN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 085.002651 |
Most Important Dates
| Enumeration Date: | 08/02/2006 |
| Last Updated: | 03/12/2013 |
Provider Practice Location
455 W COURT ST
SUITE 102
KANKAKEE
IL
609013679
Practice Location Phone/Fax
| Phone: | 8159378744 |
| Fax: | 8159373528 |
Provider Mailing Location
455 W COURT ST
SUITE 102
KANKAKEE
IL
609013679
Provider Mailing Phone/Fax
| Phone: | 8159378744 |
| Fax: | 8159373528 |