Jacob Thomas Baker, APRN
Individual provider Active NPI Nurse Practitioner · Elgin, IL
NPI 1003621657 · NPPES record last updated Jun 24, 2025
Key facts
- NPI
- 1003621657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209.030458 (IL)
- Practice address
- 1530 N Randall Rd Ste 210
Elgin, IL 60123-7879 - Phone
- (224) 760-7322
- NPI assigned
- Feb 11, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chestnut Health of Illinois LLC
Practice addresses (Care Compare)
1530 N Randall Rd
Suite 210
Elgin, IL 60123-7879
Phone (224) 760-7322
Hospital & facility affiliations
- Mederi Caretenders
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250225002024 | IL | Practitioner - Nurse Practitioner | 8325568090 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.030458 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chestnut Health of Illinois LLC | Current |
Accepting new patients |
Locations
1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209.030458 | IL | Yes |
Addresses
Primary practice location
1530 N Randall Rd Ste 210
Elgin, IL 60123-7879
Mailing address
1530 N Randall Rd Ste 210
Elgin, IL 60123-7879
Phone (224) 760-7322
Other practice location 1
650 Maryville University Dr
Creve Coeur, MO 63141-5849
Phone (800) 627-9855
Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.