Healthcare Provider Details

I. General information

NPI: 1710893474
Provider Name (Legal Business Name): LILLIAN QUADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 VILLAGE DR
DOWNERS GROVE IL
60516-3048
US

IV. Provider business mailing address

1967 N HALSTED ST APT 3F
CHICAGO IL
60614-5074
US

V. Phone/Fax

Practice location:
  • Phone: 888-900-7582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242.019071
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: