Provider Demographics
NPI:1497007272
Name:BAKER, AKILAH (LCSW)
Entity Type:Individual
Prefix:
First Name:AKILAH
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15941 HARLEM AVE
Mailing Address - Street 2:126
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1609
Mailing Address - Country:US
Mailing Address - Phone:773-858-3106
Mailing Address - Fax:866-903-0238
Practice Address - Street 1:15941 HARLEM AVE
Practice Address - Street 2:126
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1609
Practice Address - Country:US
Practice Address - Phone:773-858-3106
Practice Address - Fax:866-903-0238
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0154811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical