Provider Demographics
NPI:1679190433
Name:QUINN, MEGAN (LSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:WOZNIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:850 W BARTLETT RD STE 14C
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4454
Mailing Address - Country:US
Mailing Address - Phone:630-864-7267
Mailing Address - Fax:
Practice Address - Street 1:850 W BARTLETT RD STE 14C
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4454
Practice Address - Country:US
Practice Address - Phone:630-864-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-28
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL23164141041S0200X
IL150101812104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool