Healthcare Provider Details

I. General information

NPI: 1144871120
Provider Name (Legal Business Name): DANIELLE LYNN QUINTANA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE L SCHNOEKER

II. Dates (important events)

Enumeration Date: 09/22/2019
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 HAMACHER STREET SUITE 103
WATERLOO IL
62298-2024
US

IV. Provider business mailing address

509 HAMACHER ST STE 103
WATERLOO IL
62298-1592
US

V. Phone/Fax

Practice location:
  • Phone: 618-939-3939
  • Fax: 618-939-0234
Mailing address:
  • Phone: 618-939-3939
  • Fax: 618-939-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209020607
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209020607
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: