Provider Demographics
NPI:1376139402
Name:QUIGLEY, STEVEN (CPHT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-1325
Mailing Address - Country:US
Mailing Address - Phone:815-735-3808
Mailing Address - Fax:
Practice Address - Street 1:221 SPRINGFIELD AVE STE A
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-7655
Practice Address - Country:US
Practice Address - Phone:815-727-4722
Practice Address - Fax:815-727-4731
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL049139953183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician