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Individual

MRS. ABBEY J BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4400 W 95TH ST, SUITE 205, OAK LAWN, IL 60453-2654
(708) 346-4040
(708) 346-3287
Mailing address
4400 W 95TH ST, SUITE 205, OAK LAWN, IL 60453-2654
(708) 346-4040
(708) 346-3287

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085001278
IL
363AS0400X
Surgical Physician Assistant
10000448A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01618941
BLUECROSS/BLUESHIELD
IL
Enumeration date
07/22/2005
Last updated
11/19/2009
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