Provider Demographics
NPI:1083807960
Name:BAIER, TREVOR (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:
Last Name:BAIER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2500
Mailing Address - Country:US
Mailing Address - Phone:217-326-2911
Mailing Address - Fax:217-344-8047
Practice Address - Street 1:2707 STANGE RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3965
Practice Address - Country:US
Practice Address - Phone:515-956-4016
Practice Address - Fax:515-292-7200
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7216OtherPERSONALCARE PROVIDER ID
IL4117OtherHAMP PROVIDER ID
IL203OtherBLUE CROSS PROV ID
IL113326OtherHEALTHLINK PROVIDER ID
IL203OtherBLUE CROSS PROV ID