| Constance L. Bauer, Llc | |
|
180 N Michigan Ave Suite 605 Chicago IL 60601-7401 | |
| (708) 848-0491 | |
| Not Available |
| Full Name | Constance L. Bauer, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 180 N Michigan Ave, Chicago, Illinois |
| Authorized Official Name and Position | Constance Linn Bauer (MANAGING MEMBER) |
| Authorized Official Contact | 7088480491 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Constance L. Bauer, Llc Po Box 5888 River Forest IL 60305-5888 Ph: (708) 848-0491 | Constance L. Bauer, Llc 180 N Michigan Ave Suite 605 Chicago IL 60601-7401 Ph: (708) 848-0491 |
| NPI Number | 1457532343 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 09/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457532343 | NPI | - | NPPES |
| 216943 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149009945 (Illinois) | Primary |
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