Provider Demographics
NPI:1689069189
Name:QUINLAN, LUCAS (MLS(ASCP))
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:QUINLAN
Suffix:
Gender:M
Credentials:MLS(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2172 COUNTY ROAD 3500 N
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:IL
Mailing Address - Zip Code:60949-6028
Mailing Address - Country:US
Mailing Address - Phone:217-841-4138
Mailing Address - Fax:
Practice Address - Street 1:2172 COUNTY ROAD 3500 N
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:IL
Practice Address - Zip Code:60949-6028
Practice Address - Country:US
Practice Address - Phone:217-841-4138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist