Individual provider Active NPI

Nicholette Noel Baker

  • Physical Rehabilitation Occupational Therapist
  • Glenview, IL
National Provider Identifier
1003480609
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
5201014092 Issued in MI
Practice address
2600 Compass Rd
Glenview, IL 60026-8001
Phone
(877) 787-3430
NPI assigned
May 18, 2021
Reactivated
Feb 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Physical Rehabilitation Occupational Therapist 225XP0019X 5201014092 MI Primary

Addresses

Primary practice location

2600 Compass Rd
Glenview, IL 60026-8001

Mailing address

51145 Nicolette Dr
Chesterfield, MI 48047-4585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201014092MIMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1003480609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51145 NICOLETTE DR",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480474585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001",
            "telephone_number": "877-787-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "NICHOLETTE",
        "middle_name": "NOEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "deactivation_date": "2025-01-24",
        "reactivation_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MI",
            "license": "5201014092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.