Provider Demographics
NPI:1932190741
Name:BAKER, ROBERT S (MA,NCC,LCPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:BAKER
Suffix:
Gender:M
Credentials:MA,NCC,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 S BEVERLY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2704
Mailing Address - Country:US
Mailing Address - Phone:847-331-7111
Mailing Address - Fax:847-577-1700
Practice Address - Street 1:1430 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4830
Practice Address - Country:US
Practice Address - Phone:847-331-7111
Practice Address - Fax:847-577-1700
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-01
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILHUIL0311OtherCORPHEALTH/HUMANAPROVIDER
IL01632414OtherBCBSIL PROVIDER NUMBER