Healthcare Provider Details

I. General information

NPI: 1205701125
Provider Name (Legal Business Name): AMBER BAER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 JUMER DR STE A
BLOOMINGTON IL
61704-0914
US

IV. Provider business mailing address

1709 JUMER DR STE A
BLOOMINGTON IL
61704-0914
US

V. Phone/Fax

Practice location:
  • Phone: 309-463-5800
  • Fax: 833-914-2704
Mailing address:
  • Phone: 309-463-5800
  • Fax: 833-914-2704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number041513765
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041513765
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: