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Individual

DR. DEAN A BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
7427 LAKE ST, RIVER FOREST, IL 60305-1817
(708) 771-3334
(708) 771-9614
Mailing address
7427 LAKE ST, RIVER FOREST, IL 60305-1817
(708) 771-3334
(708) 771-9614

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007976
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1607956
BC/BS ILLINOIS
IL
01
362658561
FED TAX ID #
IL
Enumeration date
07/19/2006
Last updated
06/16/2009
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