Healthcare Provider Details

I. General information

NPI: 1538389515
Provider Name (Legal Business Name): ACORN PODIATRY CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 04/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 LAKE ST 202
OAK PARK IL
60301-6705
US

IV. Provider business mailing address

1144 LAKE ST 202
OAK PARK IL
60301-6705
US

V. Phone/Fax

Practice location:
  • Phone: 708-848-8013
  • Fax: 708-848-8354
Mailing address:
  • Phone: 708-848-8013
  • Fax: 708-848-8354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number016003835
License Number StateIL

VIII. Authorized Official

Name: DR. WILLIAM JAMES FINN
Title or Position: PRESIDENT
Credential: DPM
Phone: 708-848-8014