Individual
KIMBERLY ANN BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1124 ESSINGTON RD, JOLIET, IL 60435-8423
(815) 744-8554
Mailing address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 758-8674
(815) 758-7298
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036130506
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400368523
MEDICARE INDIVIDUAL
IL
Enumeration date
05/27/2007
Last updated
05/12/2017
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