MEDICARE: MR. HOWARD R BAKER D.O.

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	207R00000X	Internal Medicine Physician	036087725	IL

General Provider Information

NPI Number	:	1558326439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HOWARD R BAKER D.O.

Provider Business Mailing Address
First Line	:	3220 W IL ROUTE 60
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060
Country	:	US
Telephone Number	:	847-837-8442
Fax Number	:	847-837-8542

Provider Business Practice Location Address
First Line	:	870 N MILWAUKEE AVE FL 2
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1521
Country	:	US
Telephone Number	:	847-535-7157
Fax Number	:	847-535-8210

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	11/22/2023

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