Healthcare Provider Details

I. General information

NPI: 1083542518
Provider Name (Legal Business Name): ASHLEY BAUMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY SCHROCK

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAJOR ST
EUREKA IL
61530-1246
US

IV. Provider business mailing address

408 BAYSIDE DR
GERMANTOWN HILLS IL
61548-9093
US

V. Phone/Fax

Practice location:
  • Phone: 309-304-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041443655
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: