Raymond Charles Baker, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-004865 Issued in IL

Practice address

809 W Detweiller Dr Ste 819
Peoria, IL 61615-2198

Phone

(309) 698-6792

Fax

(309) 698-6792

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1972526838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W DETWEILLER DR STE 819",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152198",
            "telephone_number": "309-698-6792",
            "fax_number": "309-681-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W DETWEILLER DR STE 819",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152198",
            "telephone_number": "309-698-6792",
            "fax_number": "309-698-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "RAYMOND",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE #",
            "identifier": "071-004865",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madhuri Bajaj, MD
• Richard Bak
• Mari B Baker, M.D.
• Michelle Sue Baker, LCPC CADC
• Nathaniel James Baker, MD
• Sylwia Patrycja Balata
• Brooke B Baldi, MD
• James Jeffery Baldi, DDS
• Terry L Baldwin, M.D.
• Alexander Joseph Bale, DO

• Clinical Psychologist in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.