MEDICARE: DR. JOSEPH JAMES BALDINO DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	003800998	IL

General Provider Information

NPI Number	:	1417932419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH JAMES BALDINO DC

Provider Business Mailing Address
First Line	:	3805 E MAIN ST STE G
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-2487
Country	:	US
Telephone Number	:	331-222-9667
Fax Number	:	331-222-9657

Provider Business Practice Location Address
First Line	:	3805 E MAIN ST STE G
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-2487
Country	:	US
Telephone Number	:	331-222-9667
Fax Number	:	331-222-9657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	05/11/2021

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