Individual
DR. RAYMOND CHARLES BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
809 W DETWEILLER DR STE 819, PEORIA, IL 61615-2198
(309) 698-6792
(309) 698-6792
Mailing address
809 W DETWEILLER DR STE 819, PEORIA, IL 61615-2198
(309) 698-6792
(309) 681-0182
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
071-004865
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071-004865
PROFESSIONAL LICENSE #
IL
Enumeration date
07/25/2006
Last updated
04/11/2025
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