Individual
JEFFREY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
(630) 584-7762
Mailing address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
(630) 584-7762
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
978908
IL
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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