Provider Demographics
NPI:1255655312
Name:BAUMGARTNER, JAMI LYNN
Entity Type:Individual
Prefix:MS
First Name:JAMI
Middle Name:LYNN
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 PELICAN LN
Mailing Address - Street 2:
Mailing Address - City:PEOTONE
Mailing Address - State:IL
Mailing Address - Zip Code:60468-8702
Mailing Address - Country:US
Mailing Address - Phone:708-925-7173
Mailing Address - Fax:
Practice Address - Street 1:707 PELICAN LN
Practice Address - Street 2:
Practice Address - City:PEOTONE
Practice Address - State:IL
Practice Address - Zip Code:60468-8702
Practice Address - Country:US
Practice Address - Phone:708-925-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist