Provider Demographics
NPI:1457564874
Name:QUILLIN, SUSAN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:QUILLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:2726 HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-1078
Mailing Address - Country:US
Mailing Address - Phone:815-436-3969
Mailing Address - Fax:630-844-2065
Practice Address - Street 1:THE ASSOCIATION FOR INDIVIDUAL DEVELOPMENT (AID)
Practice Address - Street 2:309 NEW INDIAN TRAIL COURT
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2494
Practice Address - Country:US
Practice Address - Phone:630-966-4168
Practice Address - Fax:630-844-9011
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator