Organization
SAM BAKER OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM BAKER (PRESIDENT)
(630) 513-9566
Entity
Organization
Contact information
Practice address
150 SMITH RD, ST CHARLES, IL 60174-5203
(630) 513-9566
(630) 513-9786
Mailing address
150 SMITH RD, ST CHARLES, IL 60174-5203
(630) 513-9566
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009651
IL
Other
Enumeration date
07/22/2009
Last updated
04/03/2012
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