Provider Demographics
NPI:1750624581
Name:QUINONES, JOLENE M (APN)
Entity type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:M
Last Name:QUINONES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:M
Other - Last Name:BUCINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:6649 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2419
Mailing Address - Country:US
Mailing Address - Phone:773-586-2100
Mailing Address - Fax:773-586-2157
Practice Address - Street 1:6649 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2419
Practice Address - Country:US
Practice Address - Phone:773-586-2100
Practice Address - Fax:773-586-2157
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily