Bayer, Keith Russell

Bayer, Keith Russell is an sole proprietor health care provider with primary practice located at 5225 Old Orchard Rd Suite 34, Skokie IL 60077-4405. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bayer, Keith Russell can be contacted via phone (847) 231-3729.

Contact Information

Primary practice address
5225 Old Orchard Rd Suite 34 Skokie IL 60077-4405
Fax: (847) 581-1895
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149011633 Illinois

Profile Details

NPI number 1316996085
LBN Legal business name Bayer, Keith Russell
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2006
Last updated Oct 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316996085 NPPES
Illinois Other 01635849 BCBS-IL PROVIDER NUMBER

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