MEDICARE: DR. SANFORD BAIM M.D.

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	036-050354	IL
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036-050354	IL
3	207RR0500X	Rheumatology Physician	036-050354	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110047729	OTHER	WI	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1841227311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANFORD BAIM M.D.

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST STE 250
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3861
Country	:	US
Telephone Number	:	312-942-6163
Fax Number	:	312-563-2096

Provider Business Practice Location Address
First Line	:	1725 W HARRISON ST STE 250
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3861
Country	:	US
Telephone Number	:	312-942-6163
Fax Number	:	312-563-2096

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/13/2023

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Directions to “ DR. SANFORD BAIM M.D.” Practice Location

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