Provider Demographics
NPI:1891180436
Name:MCQUISTON, MEREDITH (LCSW)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:MCQUISTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N DEARBORN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-5358
Mailing Address - Country:US
Mailing Address - Phone:312-970-1087
Mailing Address - Fax:312-291-9723
Practice Address - Street 1:650 N DEARBORN ST STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-5358
Practice Address - Country:US
Practice Address - Phone:312-970-1087
Practice Address - Fax:312-291-9723
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
IL1490200541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker