Provider Demographics
NPI:1285686659
Name:BAIRD, JAMES (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 S. BARRINGTON ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010
Mailing Address - Country:US
Mailing Address - Phone:847-381-5011
Mailing Address - Fax:847-381-5052
Practice Address - Street 1:1410 S. BARRINGTON ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:847-381-5011
Practice Address - Fax:847-381-5052
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-003540213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016005120Medicaid
IL60001380OtherBCBC OF ILLIONOIS
IL480020436OtherMEDICARE RR PROVIDER #
ILCE8840OtherMEDICARE RR GROUP #
IL0707390001OtherDMERC
ILP00383534OtherMEDICARE RR PTAN
ILK18497Medicare UPIN
ILCE8840OtherMEDICARE RR GROUP #