Healthcare Provider Details

I. General information

NPI: 1114747060
Provider Name (Legal Business Name): QUALITY CARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5789 CORDOVA RD
ERIE IL
61250-9740
US

IV. Provider business mailing address

5789 CORDOVA RD
ERIE IL
61250-9740
US

V. Phone/Fax

Practice location:
  • Phone: 863-221-2351
  • Fax: 309-515-1044
Mailing address:
  • Phone: 863-221-2351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHANNON FRY
Title or Position: MSN APRN CEO
Credential: NP
Phone: 863-221-2351