Provider Demographics
NPI:1821851403
Name:QUINLAN, TIMOTHY JR (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:QUINLAN
Suffix:JR
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9161 MERION DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4798
Mailing Address - Country:US
Mailing Address - Phone:708-873-0626
Mailing Address - Fax:
Practice Address - Street 1:9650 W 131ST ST
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1640
Practice Address - Country:US
Practice Address - Phone:708-361-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051306112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist