Provider Demographics
NPI:1760505762
Name:BAKER, MARSHA M (OTR)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:440 N ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2310
Mailing Address - Country:US
Mailing Address - Phone:630-833-5654
Mailing Address - Fax:630-833-5654
Practice Address - Street 1:420 N WABASH AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3568
Practice Address - Country:US
Practice Address - Phone:312-893-7223
Practice Address - Fax:312-755-2255
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics