Provider Demographics
NPI:1518030097
Name:BAER, JILL M (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:BAER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:605 MULBERRY GROVE CT
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7081
Mailing Address - Country:US
Mailing Address - Phone:636-527-9111
Mailing Address - Fax:
Practice Address - Street 1:3009 N BALLAS RD
Practice Address - Street 2:SUITE 257-C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-569-2112
Practice Address - Fax:314-569-1270
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR75642080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine