Individual
DR. ANGELA LOUISE BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3313 PATRIOT COURT, HERRIN, IL 62948-3782
(618) 993-9910
(618) 993-2774
Mailing address
3313 PATRIOT COURT, HERRIN, IL 62948-3782
(618) 993-9910
(618) 993-2774
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38010854
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032066
BLUE CROSS BLUE SHIELD IL
IL
01
—
208744937
TAX ID
IL
Enumeration date
01/09/2007
Last updated
09/19/2012
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