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General NPI Number Information
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NPI Number | 1871114025
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Entity Type | Organization
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Legal Business Name | QUICKCARE, PLLC
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 6419 W TOUHY AVE APT 4A
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City | CHICAGO
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State | IL
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Zip | 60646-1040
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Country | US
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Telephone | 708-469-8973
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Fax |
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Provider Business Mailing Address
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Address Line | 6419 W TOUHY AVE APT 4A
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City | CHICAGO
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State | IL
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Zip | 60646-1040
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Country | US
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Telephone | 708-469-8973
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | QUEENESTER GRAY
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Credential | FNP
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Telephone | 708-469-8973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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