Healthcare Provider Details

I. General information

NPI: 1902215346
Provider Name (Legal Business Name): KATHLEEN FINNEGAN M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S ROUTE 30 STE LL104
PLAINFIELD IL
60544-5689
US

IV. Provider business mailing address

111 CHARITY AVE
JOLIET IL
60433-2701
US

V. Phone/Fax

Practice location:
  • Phone: 815-230-3776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227.002423
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: