Provider Demographics
NPI:1821246687
Name:BAILEY, CARA F
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:F
Last Name:BAILEY
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:PO BOX 162
Mailing Address - Street 2:1510 W. OTTAWA RD
Mailing Address - City:PAXTON
Mailing Address - State:IL
Mailing Address - Zip Code:60957
Mailing Address - Country:US
Mailing Address - Phone:217-379-4302
Mailing Address - Fax:217-379-4306
Practice Address - Street 1:1510 W OTTAWA RD
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:IL
Practice Address - Zip Code:60957
Practice Address - Country:US
Practice Address - Phone:217-379-4302
Practice Address - Fax:217-379-4306
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor