Provider Demographics
NPI:1134677065
Name:QUIGLEY, MARTHA ELIZABETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ELIZABETH
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 W 22ND ST STE 22
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4637
Mailing Address - Country:US
Mailing Address - Phone:630-317-7478
Mailing Address - Fax:630-506-8272
Practice Address - Street 1:2603 W 22ND ST STE 22
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4637
Practice Address - Country:US
Practice Address - Phone:630-317-7478
Practice Address - Fax:630-506-8272
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily