Provider Demographics
NPI:1942259411
Name:BAKER, TONYA MARIE (ATC)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 CHILLEM DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-3312
Mailing Address - Country:US
Mailing Address - Phone:630-761-8377
Mailing Address - Fax:630-389-9943
Practice Address - Street 1:2900 FOXFIELD RD
Practice Address - Street 2:SUITE LLA
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-5799
Practice Address - Country:US
Practice Address - Phone:630-853-0966
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist