Provider Demographics
NPI:1518025576
Name:BASKIN, WARREN (DC)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:BASKIN
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 1:1535 LAKE COOK RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1447
Mailing Address - Country:US
Mailing Address - Phone:847-272-0500
Mailing Address - Fax:847-272-0500
Practice Address - Street 1:1535 LAKE COOK RD
Practice Address - Street 2:SUITE 212
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1447
Practice Address - Country:US
Practice Address - Phone:847-272-0500
Practice Address - Fax:847-272-0500
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-003870111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06082032OtherBLUE CROSS BLUE SHIELD
IL06082032OtherBLUE CROSS BLUE SHIELD