MEDICARE: DR. JULIAN E BAILES JR. MD

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	207T00000X	Neurological Surgery Physician	20146	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225138001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIAN E BAILES JR. MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:	304-293-6963

Provider Business Practice Location Address
First Line	:	1000 CENTRAL ST STE 880
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1780
Country	:	US
Telephone Number	:	847-570-1440
Fax Number	:

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	02/18/2021

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