Provider Demographics
NPI:1366526931
Name:BECKER, ALAN LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEE
Last Name:BECKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 S CUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2916
Mailing Address - Country:US
Mailing Address - Phone:708-386-8255
Mailing Address - Fax:
Practice Address - Street 1:9909 W ROOSEVELT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2773
Practice Address - Country:US
Practice Address - Phone:708-344-7784
Practice Address - Fax:708-344-7780
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19174161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice