Sam Baker OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009651 Issued in IL

Legal business name

SAM BAKER OD PC

Practice address

150 Smith Rd
St Charles, IL 60174-5203

Phone

(630) 513-9566

Fax

(630) 513-9786

NPI assigned

Jul 22, 2009

Organization subpart

No

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

Authorized official

Name

Sam Baker

Title

President

Phone

(630) 513-9566

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1639309701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SMITH RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745203",
            "telephone_number": "630-513-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SMITH RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745203",
            "telephone_number": "630-513-9566",
            "fax_number": "630-513-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM BAKER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-513-9566"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saint Charles Medical PLLC
• Miriam Salazar
• Patricia Ann Salchert, OT
• Susan Salinas, MSW
• Abby Deanne Saloga, APRN, FNP-C
• Samsara Wellness
• Michelle Sanchez
• Heather Sandall, MOT, OTR/L
• James Joseph Sanders, M.D.
• Rebecca Sanford, LMT

• Optometrist in St Charles, IL
• Providers in St Charles, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.