Dawn Baker, CSFA

Individual provider Active NPI Surgical Assistant · Normal, IL

NPI 1902156995 · NPPES record last updated Sep 17, 2012

Key facts

NPI
1902156995
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
Practice address
1604 Visa Dr
Ste. 2
Normal, IL 61761-2195
Phone
(309) 846-4716
NPI assigned
Sep 17, 2012
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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Your Extra Hands Surgical Services Surgical Assistant Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X Yes

Addresses

Primary practice location

1604 Visa Dr
Ste. 2
Normal, IL 61761-2195

Mailing address

1604 Visa Dr
Ste. 2
Normal, IL 61761-2195
Phone (309) 846-4716

Other providers in Normal, IL

All providers in Normal, IL · Surgical Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.