MEDICARE: DR. PETER MARK FINK M.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	2084F0202X	Forensic Psychiatry Physician	036-049948	IL
2	2084P0800X	Psychiatry Physician	036-049948	IL
3	2084P0804X	Child & Adolescent Psychiatry Physician	036-049948	IL

General Provider Information

NPI Number	:	1942270509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER MARK FINK M.D.

Provider Business Mailing Address
First Line	:	4711 GOLF RD
Second Line	:	SUITE 700
City	:	SKOKIE
State	:	IL
Zip	:	60076-1224
Country	:	US
Telephone Number	:	847-674-4704
Fax Number	:

Provider Business Practice Location Address
First Line	:	4711 GOLF RD
Second Line	:	SUITE 700
City	:	SKOKIE
State	:	IL
Zip	:	60076-1224
Country	:	US
Telephone Number	:	847-674-4704
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	09/07/2011

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