Provider Demographics
NPI:1720499056
Name:MELINDA BALDWIN LLC
Entity Type:Organization
Organization Name:MELINDA BALDWIN LLC
Other - Org Name:MELINDA BALDWIN PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:847-828-4376
Mailing Address - Street 1:835 ASH ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2401
Mailing Address - Country:US
Mailing Address - Phone:847-828-4376
Mailing Address - Fax:847-441-8999
Practice Address - Street 1:193 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3309
Practice Address - Country:US
Practice Address - Phone:847-828-4376
Practice Address - Fax:847-441-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007921261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy