Geraldine B Baird, APN
Individual provider Active NPI Nurse Practitioner · Normal, IL
NPI 1336396324 · NPPES record last updated Aug 21, 2008
Key facts
- NPI
- 1336396324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209007152 (IL)
- Practice address
- 1300 Franklin Ave
Normal, IL 61761-3592 - Phone
- (309) 454-1400
- NPI assigned
- Aug 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209007152 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Pain Center of Lake County | Past | Accepting new patients | |
| Millennium Pain Center LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209007152 | IL | Yes |
Addresses
Primary practice location
1300 Franklin Ave
Normal, IL 61761-3592
Mailing address
5198 Reliable Pkwy
Chicago, IL 60686-0001
Phone (800) 444-6110
Other names
- Geraldine B Baclay
Other providers in Normal, IL
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- Kacey Ayres
- Jara Bachtold
- Back to Health of B/N, Inc
- Juan Fabien Baez
- Dawn Baker
- Loretta Baker
- Balance Within Wellness PLLC
- Karen Jane Bandusch Harris
- Barnes Dental Associates
All providers in Normal, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2008. 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.