Healthcare Provider Details

I. General information

NPI: 1316948938
Provider Name (Legal Business Name): STEPHEN A. BAKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2005
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 GUNDERSEN DR SUITE A
CAROL STREAM IL
60188-2402
US

IV. Provider business mailing address

327 GUNDERSEN DR SUITE A
CAROL STREAM IL
60188-2402
US

V. Phone/Fax

Practice location:
  • Phone: 630-665-9155
  • Fax: 630-665-5557
Mailing address:
  • Phone: 630-665-9155
  • Fax: 630-665-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036060377
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: