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General NPI Number Information
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NPI Number | 1952612335
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Entity Type | Organization
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Legal Business Name | JOHN MICHAEL QUINN & ASSOCIATES
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 2200 S MAIN ST SUITE 305
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City | LOMBARD
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State | IL
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Zip | 60148-5334
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Country | US
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Telephone | 630-408-8108
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 S MAIN ST SUITE 305
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City | LOMBARD
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State | IL
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Zip | 60148-5334
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Country | US
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Telephone | 630-408-8108
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN MICHAEL QUINN
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Credential | LCPC, CADC
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Telephone | 630-408-8108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 27416
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180006854
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License Number State | IL
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