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
Phone: (773) 834-4064
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275698003 | NPPES |
| Illinois | MEDICAID | 019019898 |
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