Justin Baker

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Vernon Hills, IL

NPI 1871869032 · NPPES record last updated Mar 31, 2012

Key facts

NPI
1871869032
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
24647 N Milwaukee Ave
Vernon Hills, IL 60061-1567
Phone
(847) 377-7950
Fax
(847) 984-5635
NPI assigned
Mar 31, 2012
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

24647 N Milwaukee Ave
Vernon Hills, IL 60061-1567

Mailing address

3010 Grand Ave
Waukegan, IL 60085-2321
Phone (847) 377-8296

Other providers in Vernon Hills, IL

All providers in Vernon Hills, IL · Addiction (Substance Use Disorder) Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.