Katie Ann Baker – Occupational Therapy Assistant

Key facts

NPI: 1639720709
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapy Assistant 224Z00000X
License: 057.005248 (IL)
Practice address: 7421 Madison St
Unit 1
Forest Park, IL 60130
Phone: (847) 909-1490
NPI assigned: Sep 20, 2019
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Pop Pediatric Therapy Services, LLC Pediatric Occupational Therapist · Forest Park, IL · NPI 1639733959

NPD (past) OCCUPATIONAL THERAPY ASSISTANT

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
057.005248	IL	MD	Occupational Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Pop Pediatric Therapy Services, LLC	Occupational Therapy Assistant	Past since Sep 25, 2019	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapy Assistant	224Z00000X	057.005248	IL	Yes

Addresses

Primary practice location

7421 Madison St
Unit 1
Forest Park, IL 60130

Mailing address

7421 Madison St
Unit 1
Forest Park, IL 60130
Phone (847) 909-1490

Other providers in Forest Park, IL

All providers in Forest Park, IL · Occupational Therapy Assistant in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2019. 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.

Verify at the official NPI Registry.