Healthcare Provider Details

I. General information

NPI: 1023838794
Provider Name (Legal Business Name): QINGHUI LIU APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E GRANT ST
MACOMB IL
61455-3318
US

IV. Provider business mailing address

4115 HERLEMAN RD
QUINCY IL
62305-8241
US

V. Phone/Fax

Practice location:
  • Phone: 309-833-4101
  • Fax:
Mailing address:
  • Phone: 309-252-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.033517
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: