Provider Demographics
NPI:1518545458
Name:PIRKLE, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:PIRKLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 E 57TH ST # 104
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1455
Mailing Address - Country:US
Mailing Address - Phone:773-702-1937
Mailing Address - Fax:
Practice Address - Street 1:924 E 57TH ST # 104
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1455
Practice Address - Country:US
Practice Address - Phone:773-702-1937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program