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Contact Information

LUANN BAUER
63 N WILLIAMS ST
CRYSTAL LAKE, IL60014-4443
 Phone: 815-356-9900
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Point of Service

305S00000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1184192643
Entity Organization
Organization subpart 1 Not specified
Enumeration date 11/02/2018
Last updated 11/02/2018 - About 8 years ago
Identifiers
IL License # 20-1975060
IL Other 20-1975060 TAX ID #
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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