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NPI Code Detail

MEDICARE: KIMBERLY FINNEGAN

MEDICARE: KIMBERLY FINNEGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209015046IL

General Provider Information

NPI Number : 1134661366
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY FINNEGAN
Provider Business Mailing Address
First Line : 3030 N MOBILE AVE
Second Line : PCC COMMUNITY WELLNESS CENTER
City : CHICAGO
State : IL
Zip : 60634-4041
Country : US
Telephone Number : 773-622-5679
Fax Number : 773-622-5814
Provider Business Practice Location Address
First Line : 3030 N MOBILE AVE
Second Line : PCC COMMUNITY WELLNESS CENTER
City : CHICAGO
State : IL
Zip : 60634-4041
Country : US
Telephone Number : 773-622-5679
Fax Number : 773-622-5814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2016
Last Update Date : 01/02/2020

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Directions to “ KIMBERLY FINNEGAN ” Practice Location

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