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General NPI Number Information
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NPI Number | 1952380479
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Entity Type | Individual
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Provider Name | DIANE MARIE BAYLOR OTR/L,CHT
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Gender | Female
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 795 SUMMIT ST
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City | ELGIN
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State | IL
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Zip | 60120-5160
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Country | US
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Telephone | 847-289-6500
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Fax | 847-289-6700
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-1925
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Country | US
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Telephone | 630-575-1980
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Fax | 630-928-5080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 056-002019
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056002019
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License Number State | IL
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