Provider Demographics
NPI:1417932419
Name:BALDINO, JOSEPH JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAMES
Last Name:BALDINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 E MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2487
Mailing Address - Country:US
Mailing Address - Phone:331-222-9667
Mailing Address - Fax:331-222-9657
Practice Address - Street 1:3805 E MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2487
Practice Address - Country:US
Practice Address - Phone:331-222-9667
Practice Address - Fax:331-222-9657
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL003800998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
K09393Medicare ID - Type Unspecified
U 96814Medicare UPIN