| Doctor Name: | BEVERLY L DECK |
| NPI Number: | 1043308828 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 036087476 |
| Business Practice Address: | 7318 Madison St Forest Park, IL - 601303100 |
| Business Phone Number: | 7085601960 |
| Business Fax Number: | |
| Mailing Address: | 7318 Madison St, FOREST PARK |
| State: | IL |
| Postal Code: | 601303100 |
| Phone Number: | 7085601960 |
| Fax Number: | |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 06/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036087476 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |