MEDICARE: MICHAEL R BAUER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	036083114	IL

General Provider Information

NPI Number	:	1205832128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL R BAUER M.D.

Provider Business Mailing Address
First Line	:	1632 W CENTRAL RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2407
Country	:	US
Telephone Number	:	847-618-2500
Fax Number	:	847-253-8474

Provider Business Practice Location Address
First Line	:	1632 W CENTRAL RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2407
Country	:	US
Telephone Number	:	847-618-2500
Fax Number	:	847-253-8474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	04/26/2021

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