NPI 1184192643

Luann Bauer

Practitioner Point of Service Crystal Lake, IL

Practice location

Address: 63 N Williams St, Crystal Lake, IL 60014-4443
Phone: (815) 356-9900

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 20-1975060 (IL)

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Registry record

NPI: 1184192643
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Nov 2018
Record last updated: 2 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.