Provider Demographics
NPI:1285181297
Name:BAUMANN, ASHLEY (BS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S MAY ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4229
Mailing Address - Country:US
Mailing Address - Phone:312-602-1469
Mailing Address - Fax:
Practice Address - Street 1:1100 S MAY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4229
Practice Address - Country:US
Practice Address - Phone:312-602-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1407971211Medicaid