Individual
CAROL M BAUER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 N 8TH ST, SPRINGFIELD, IL 62701-1041
(217) 545-6099
(217) 545-0253
Mailing address
720 N BOND ST, PO BOX 19639, SPRINGFIELD, IL 62794
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036091175
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091175
—
IL
Enumeration date
09/16/2005
Last updated
02/18/2020
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