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Individual

PETER BAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 758-8671
(815) 758-5610
Mailing address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 758-8671
(815) 758-5610

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
036-061024
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008447
HEALTH ALLIANCE
IL
05
036061024
IL
Enumeration date
08/05/2006
Last updated
10/28/2011
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