Baer, Russell A

Baer, Russell A is an individual health care provider with primary practice located at 222 N Lasalle St 230, Chicago IL 60601-1002. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Baer, Russell A can be contacted via phone (773) 834-4064.

Contact Information

Primary practice address
222 N Lasalle St 230 Chicago IL 60601-1002
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 019019898 Illinois

Profile Details

NPI number 1275698003
LBN Legal business name Baer, Russell A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2006
Last updated Mar 3rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275698003 NPPES
Illinois MEDICAID 019019898

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