Mr Richard Jospeh Baker, | |
1401 E 12th St, Mendota, IL 61342-9216 | |
(815) 875-6001 | |
(815) 875-3612 |
Full Name | Mr Richard Jospeh Baker |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 15 Years |
Location | 1401 E 12th St, Mendota, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376879122 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 209007858 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Quantum Anesthesia Services Llc | 7618100751 | 4 |
Entity Name | Methodist Medical Center Of Illinois |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164474755 PECOS PAC ID: 1355259714 Enrollment ID: O20070924000481 |
Entity Name | Central Illinois Anesthesiology Associates, Ltd |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770887267 PECOS PAC ID: 0547444507 Enrollment ID: O20110415000355 |
Entity Name | Quantum Anesthesia Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033546833 PECOS PAC ID: 7618100751 Enrollment ID: O20140425001247 |
Mailing Address | Practice Location Address |
---|---|
Mr Richard Jospeh Baker, 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 539-7461 | Mr Richard Jospeh Baker, 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 875-6001 |
Kenneth K Potts, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1401 East 12th Street, Mendota, IL 61342 Phone: 815-539-7461 Fax: 815-539-1461 | |
James F Meyer, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1401 East 12th Street, Mendota, IL 61342 Phone: 815-539-7461 Fax: 815-539-1461 |