Provider Demographics
NPI:1790213775
Name:FINK, JOEL
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:FINK
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 1:730 W COUCH PL UNIT 2604
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1386
Mailing Address - Country:US
Mailing Address - Phone:610-416-0259
Mailing Address - Fax:
Practice Address - Street 1:730 WEST COUCH PLACE APT 2604
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661
Practice Address - Country:US
Practice Address - Phone:610-416-0259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250798142083X0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program