Healthcare Provider Details

I. General information

NPI: 1275460735
Provider Name (Legal Business Name): BAILEY HELENE QUAKA MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GORE RD
MORRIS IL
60450-9466
US

IV. Provider business mailing address

1885 S HADDEN RD
MAZON IL
60444-6071
US

V. Phone/Fax

Practice location:
  • Phone: 815-364-8919
  • Fax:
Mailing address:
  • Phone: 815-735-2577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.035444
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: