Provider Demographics
| NPI: | 1891202602 |
|---|---|
| Name: | THE BABY DOCTOR AND COMPANY |
| Entity Type: | Organization |
| Organization Name: | THE BABY DOCTOR AND COMPANY |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ANGELA |
| Authorized Official - Middle Name: | PATRICIA |
| Authorized Official - Last Name: | MARCOTTE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | DPT |
| Authorized Official - Phone: | 224-288-8797 |
| Mailing Address - Street 1: | 600 BASIL RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LAKE BLUFF |
| Mailing Address - State: | IL |
| Mailing Address - Zip Code: | 60044-1704 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 600 BASIL RD |
| Practice Address - Street 2: | |
| Practice Address - City: | LAKE BLUFF |
| Practice Address - State: | IL |
| Practice Address - Zip Code: | 60044-1704 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 847-964-3752 |
| Practice Address - Fax: | 847-574-5902 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-01-02 |
| Last Update Date: | 2023-03-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 174400000X | Other Service Providers | Specialist | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |
