Provider Demographics
NPI:1194846766
Name:QUINONES, CINDIA
Entity Type:Individual
Prefix:
First Name:CINDIA
Middle Name:
Last Name:QUINONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 410534
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-0534
Mailing Address - Country:US
Mailing Address - Phone:773-817-2074
Mailing Address - Fax:773-478-4599
Practice Address - Street 1:2957 N KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7603
Practice Address - Country:US
Practice Address - Phone:773-817-2074
Practice Address - Fax:773-478-4599
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist