Provider Demographics
NPI:1669413647
Name:BAUER, CORIANN (DC)
Entity type:Individual
Prefix:
First Name:CORIANN
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7741
Mailing Address - Country:US
Mailing Address - Phone:630-881-9106
Mailing Address - Fax:
Practice Address - Street 1:8600 W BRYN MAWR AVE STE 100N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3544
Practice Address - Country:US
Practice Address - Phone:773-930-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK36008OtherMEDICARE #
IL1635132OtherBLUE CROSS ID #
ILK36008OtherMEDICARE #
IL211559Medicare PIN