Provider Demographics
NPI:1326020504
Name:BEHR, JEFFREY T (MD)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:T
Last Name:BEHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2902 MCFARLAND RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6801
Mailing Address - Country:US
Mailing Address - Phone:815-316-2100
Mailing Address - Fax:815-316-2099
Practice Address - Street 1:2902 MCFARLAND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6801
Practice Address - Country:US
Practice Address - Phone:815-316-2100
Practice Address - Fax:815-316-2099
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036064728 2Medicaid
ILD16210Medicare UPIN
ILL97893Medicare ID - Type Unspecified