Provider Demographics
NPI:1952612335
Name:JOHN MICHAEL QUINN & ASSOCIATES
Entity Type:Organization
Organization Name:JOHN MICHAEL QUINN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CADC
Authorized Official - Phone:630-408-8108
Mailing Address - Street 1:2200 S MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5334
Mailing Address - Country:US
Mailing Address - Phone:630-408-8108
Mailing Address - Fax:
Practice Address - Street 1:2200 S MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5334
Practice Address - Country:US
Practice Address - Phone:630-408-8108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL27416101YA0400X
IL180006854101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty