Individual provider Active NPI

Steven Thad Baker

  • Registered Nurse
  • North Chicago, IL
National Provider Identifier
1275101891
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.289912 Issued in IL
Practice address
2450 Buckley Rd
North Chicago, IL 60064-3092
Phone
(847) 688-1900
NPI assigned
Jun 11, 2021
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.289912 IL Primary

Addresses

Primary practice location

2450 Buckley Rd
North Chicago, IL 60064-3092

Mailing address

375 W Winchester Rd Apt 204
Libertyville, IL 60048-3916
Phone (847) 702-3097

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
041.289912ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1275101891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W WINCHESTER RD APT 204",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483916",
            "telephone_number": "847-702-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 BUCKLEY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643092",
            "telephone_number": "847-688-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "STEVEN",
        "middle_name": "THAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.289912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.