Healthcare Provider Details

I. General information

NPI: 1871412270
Provider Name (Legal Business Name): SYLVESTER BAKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10540 S WESTERN AVE STE 208
CHICAGO IL
60643-2529
US

IV. Provider business mailing address

7538 S WABASH AVE
CHICAGO IL
60619-1608
US

V. Phone/Fax

Practice location:
  • Phone: 773-450-1495
  • Fax:
Mailing address:
  • Phone: 773-450-1495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: