Provider Demographics
NPI:1679820831
Name:BECKER, JULIE LOUISE (OD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LOUISE
Last Name:BECKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:22200 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-7721
Mailing Address - Country:US
Mailing Address - Phone:815-534-5102
Mailing Address - Fax:815-534-5918
Practice Address - Street 1:22200 WOLF RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-7721
Practice Address - Country:US
Practice Address - Phone:815-534-5102
Practice Address - Fax:815-534-5918
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010583152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty