Provider Demographics
NPI:1972732410
Name:PINCKNEY, TODD (MA)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:PINCKNEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 SUNNYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4680
Mailing Address - Country:US
Mailing Address - Phone:630-310-7510
Mailing Address - Fax:
Practice Address - Street 1:507 THORNHILL DR STE A
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2706
Practice Address - Country:US
Practice Address - Phone:630-752-9750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program