Elizabeth Renee Baker, MS, CCC-SLP/L
Individual provider Active NPI Speech-Language Pathologist · Canton, IL
NPI 1194241208 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1194241208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.004401 (IL)
- Practice address
- 20 Lincoln Rd
Canton, IL 61520-1037 - Phone
- (309) 647-7594
- Fax
- (309) 647-2043
- NPI assigned
- Aug 21, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.004401 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.004401 | IL | Yes |
Addresses
Primary practice location
20 Lincoln Rd
Canton, IL 61520-1037
Mailing address
20 Lincoln Rd
Canton, IL 61520-1037
Phone (309) 647-7594
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All providers in Canton, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.