Provider Demographics
NPI:1528162898
Name:BAYER, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 THORNHILL DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2793
Mailing Address - Country:US
Mailing Address - Phone:630-668-3210
Mailing Address - Fax:630-668-3505
Practice Address - Street 1:501 THORNHILL DR
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2793
Practice Address - Country:US
Practice Address - Phone:630-668-3210
Practice Address - Fax:630-668-3505
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036077734207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036077734Medicaid
IL036108659OtherMEDICAID
IL206147OtherMEDICARE GROUP PTAN
ILF400144099OtherMEDICARE INDIVIDUAL PTAN
ILF400144099OtherMEDICARE INDIVIDUAL PTAN
ILL16030Medicare ID - Type Unspecified