Provider Demographics
NPI:1891786950
Name:BAKER, SHEILA DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:DENISE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:600 LINCOLN AVE
Mailing Address - Street 2:EASTERN ILLINOIS UNIVERSITY
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-3011
Mailing Address - Country:US
Mailing Address - Phone:217-581-3015
Mailing Address - Fax:217-581-3899
Practice Address - Street 1:600 LINCOLN AVE
Practice Address - Street 2:EASTERN ILLINOIS UNIVERSITY
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-3011
Practice Address - Country:US
Practice Address - Phone:217-581-3015
Practice Address - Fax:217-581-3899
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE68939Medicare UPIN