Provider Demographics
NPI:1831822170
Name:QUINLAN, KATHLEEN (MA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 CENTRAL ST APT 1N
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1258
Mailing Address - Country:US
Mailing Address - Phone:847-877-1199
Mailing Address - Fax:
Practice Address - Street 1:499 ANTHONY ST
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4468
Practice Address - Country:US
Practice Address - Phone:630-534-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional