Provider Demographics
NPI:1770566838
Name:BAKER, NANCY N/A (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:N/A
Last Name:BAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W ROOSEVELT RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5080
Mailing Address - Country:US
Mailing Address - Phone:630-668-1992
Mailing Address - Fax:630-668-2177
Practice Address - Street 1:520 W ROOSEVELT RD
Practice Address - Street 2:STE 101
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5080
Practice Address - Country:US
Practice Address - Phone:630-668-1992
Practice Address - Fax:630-668-2177
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-006297111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health