Provider Demographics
NPI:1144401936
Name:FINN, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:FINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 W EXCHANGE ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-1495
Mailing Address - Country:US
Mailing Address - Phone:815-895-9227
Mailing Address - Fax:815-895-2971
Practice Address - Street 1:245 W EXCHANGE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-1495
Practice Address - Country:US
Practice Address - Phone:815-895-9227
Practice Address - Fax:815-895-2971
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILDF26870196P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist