MEDICARE: ANDREA FINK PH.D.

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
1	103T00000X	Psychologist	71003453	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01673445	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1255330130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA FINK PH.D.

Provider Business Mailing Address
First Line	:	4256 N RAVENSWOOD AVE STE 314
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1114
Country	:	US
Telephone Number	:	773-292-9266
Fax Number	:	773-292-0639

Provider Business Practice Location Address
First Line	:	4256 N RAVENSWOOD AVE STE 314
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1114
Country	:	US
Telephone Number	:	773-292-9266
Fax Number	:	773-292-0639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	02/03/2025

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