Healthcare Provider Details

I. General information

NPI: 1699093401
Provider Name (Legal Business Name): QIANNA ARMSTRONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST STE 306
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

4440 W 95TH ST STE 306
OAK LAWN IL
60453-2600
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-5428
  • Fax:
Mailing address:
  • Phone: 708-684-5428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036.145996
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number01070178A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: