Healthcare Provider Details

I. General information

NPI: 1528682887
Provider Name (Legal Business Name): FRANCIS GUERRA-BAUMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 NW 10TH ST STE 1
FAIRFIELD IL
62837-1216
US

IV. Provider business mailing address

213 NW 10TH ST STE 1
FAIRFIELD IL
62837-1216
US

V. Phone/Fax

Practice location:
  • Phone: 618-842-4617
  • Fax: 618-842-4743
Mailing address:
  • Phone: 618-842-4617
  • Fax: 618-847-8387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036165861
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: