Provider Demographics
NPI:1770762346
Name:QUAIL, GARRETT LEONARD II (ATC)
Entity type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:LEONARD
Last Name:QUAIL
Suffix:II
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3605 HARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3832
Mailing Address - Country:US
Mailing Address - Phone:708-917-4067
Mailing Address - Fax:
Practice Address - Street 1:4555 211TH ST
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2318
Practice Address - Country:US
Practice Address - Phone:708-283-0021
Practice Address - Fax:708-283-0831
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0023782255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer