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NPI Code Detail

MEDICARE: JOHN L BAKER OD

MEDICARE: JOHN L BAKER OD
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
1152W00000XOptometrist046008191IL

General Provider Information

NPI Number : 1447243936
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN L BAKER OD
Provider Business Mailing Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4537
Provider Business Practice Location Address
First Line : 3241 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-4201
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4537
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 10/06/2025

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Directions to “ JOHN L BAKER OD” Practice Location

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