Provider Demographics
NPI:1407349152
Name:BAUMANN, PATRICIA R (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3428
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62708-3428
Mailing Address - Country:US
Mailing Address - Phone:217-726-7300
Mailing Address - Fax:217-726-5989
Practice Address - Street 1:3225 HEDLEY RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-6248
Practice Address - Country:US
Practice Address - Phone:217-726-7300
Practice Address - Fax:217-726-5989
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361558512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036155851OtherMD LICENSE