Provider Demographics
NPI:1508270240
Name:BAKER, ANN PETRUS (BSN, MPH, WHE)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:PETRUS
Last Name:BAKER
Suffix:
Gender:F
Credentials:BSN, MPH, WHE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 PARK PL
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1316
Mailing Address - Country:US
Mailing Address - Phone:847-790-6632
Mailing Address - Fax:
Practice Address - Street 1:1222 WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2615
Practice Address - Country:US
Practice Address - Phone:847-790-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator