Basic Information
Provider Information
NPI: 1295902815
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINEGAN
FirstName: JOANNA
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: MOTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10843 S FAIRFIELD AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606551722
CountryCode: US
TelephoneNumber: 7734454083
FaxNumber:  
Practice Location
Address1: 3703 WEST LAKE AVENUE
Address2: SUITE 200
City: GLENVIEW
State: IL
PostalCode: 600261223
CountryCode: US
TelephoneNumber: 8479981188
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/13/2008
LastUpdateDate: 05/13/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X056.005339ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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