Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 038-006297 | IL |
NPI | 1770566838 |
---|---|
Provider Name | Dr. Nancy N/a Baker |
First Address | Wheaton, IL 60187-5080 |
Second Address | Wheaton, IL 60187-5080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 04/04/2017 |