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General NPI Number Information
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NPI Number | 1841499183
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Entity Type | Organization
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Legal Business Name | ROBERT S BAKER MD LTD
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 4160 RT 83 STE #106
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City | LONG GROVE
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State | IL
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Zip | 60047-5083
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Country | US
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Telephone | 847-955-1139
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Fax | 815-955-1139
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Provider Business Mailing Address
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Address Line | 4160 RT 83 STE #106
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City | LONG GROVE
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State | IL
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Zip | 60047-5083
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Country | US
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Telephone | 847-955-1139
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Fax | 815-955-1139
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | FAYE FIELDS
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Credential |
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Telephone | 815-356-1559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 036058454
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License Number State | IL
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