Provider Demographics
NPI:1861755597
Name:FINN, JAMES MATTHEW (PSYD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MATTHEW
Last Name:FINN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 HARLEM BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-4816
Mailing Address - Country:US
Mailing Address - Phone:815-963-8661
Mailing Address - Fax:
Practice Address - Street 1:7117 CRIMSON RIDGE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6213
Practice Address - Country:US
Practice Address - Phone:815-633-8099
Practice Address - Fax:630-658-0543
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006549313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility