Healthcare Provider Details

I. General information

NPI: 1801720701
Provider Name (Legal Business Name): DR. JOHN MICHAEL QUINN V
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 LAKE ST # 318
OAK PARK IL
60301-1301
US

IV. Provider business mailing address

805 LAKE ST # 318
OAK PARK IL
60301-1301
US

V. Phone/Fax

Practice location:
  • Phone: 630-747-9081
  • Fax:
Mailing address:
  • Phone: 630-747-9081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number000878553
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: