Healthcare Provider Details

I. General information

NPI: 1790499580
Provider Name (Legal Business Name): DHOLLIE LYN DAYAO QUIAMCO APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8741 S GREENWOOD AVE STE 106-108
CHICAGO IL
60619-7061
US

IV. Provider business mailing address

1901 BUTTERFIELD RD STE 810
DOWNERS GROVE IL
60515-7904
US

V. Phone/Fax

Practice location:
  • Phone: 773-920-2755
  • Fax: 866-658-8674
Mailing address:
  • Phone: 480-494-2465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209026658
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.026658
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: