Provider Demographics
NPI:1871680017
Name:JOHN A. QUINN, D.D.S. PC
Entity Type:Organization
Organization Name:JOHN A. QUINN, D.D.S. PC
Other - Org Name:DEARBORN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-913-2300
Mailing Address - Street 1:539 S DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1529
Mailing Address - Country:US
Mailing Address - Phone:312-913-2300
Mailing Address - Fax:
Practice Address - Street 1:539 S DEARBORN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1529
Practice Address - Country:US
Practice Address - Phone:312-913-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19-0166051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty