Michelle Denise McQuillan, DNP, FNP-BC
Individual provider Active NPI Nurse Practitioner · O'Fallon, IL
NPI 1013533819 · NPPES record last updated Dec 13, 2024
Key facts
- NPI
- 1013533819
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209.021778 (IL)
- Practice address
- 321 Regency Park
O'Fallon, IL 62269 - Phone
- (618) 416-7970
- Fax
- (618) 416-7971
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Southern Illinois University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Hospital
Cancer Care Specialists of Central Illinois SC
Practice addresses (Care Compare)
1900 State St
Chester, IL 62233-1116
Phone (618) 826-4581
321 Regency Park
Suite 100
O Fallon, IL 62269-1887
Phone (618) 416-7970
Hospital & facility affiliations
- Memorial Hospital
- Fairfield Memorial Hospital 1
- Sparta Community Hospital
- HSHS St Elizabeth'S Hospital
- St Josephs Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200828000495 | IL | Practitioner - Nurse Practitioner | 8123445673 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.021778 | IL | MD | Nurse Practitioner |
| 209021778 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cancer Care Specialists of Central Illinois, S.C. | Current |
Accepting new patients | |
| Memorial Hospital | Current |
Accepting new patients | |
| Cancer Care Specialists of Central Illinois, S.C | Current |
Accepting new patients | |
| Memorial Hospital | Current |
Accepting new patients | |
| Memorial Hospital | Nurse Practitioner | Past | Accepting new patients |
Locations
9515 Holy Cross Ln
Ste 6
Breese, IL 62230
Phone (618) 416-7970
1052 M L King Dr
Ste 2
Centralia, IL 62801
Phone (618) 436-5410
1900 State St
Chester, IL 62233
Phone (618) 826-2388
210 W McKinley Ave
#1
Decatur, IL 62526
Phone (217) 877-9442
210 W McKinley Ave
Ste 1
Decatur, IL 62526
Phone (217) 876-6600
213 NW 10th St
Ste D
Fairfield, IL 62837
Phone (217) 329-3232
12860 Troxler Ave
Ste 135
Highland, IL 62249
Phone (618) 235-3687
321 Regency Park
Ste 100
O Fallon, IL 62269
Phone (618) 416-7970
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209021778 | IL | |
| Nurse Practitioner | 363L00000X | 209.021778 | IL | Yes |
Addresses
Primary practice location
321 Regency Park
O'Fallon, IL 62269
Mailing address
210 W. McKinley Ave.
Suite 1
Decatur, IL 62526
Phone (217) 877-9442
Other practice location 1
213 NW 10th St Ste D
Fairfield, IL 62837-1219
Phone (217) 329-3232
Other practice location 2
9515 Holy Cross Ln Ste 6
Breese, IL 62230-3618
Phone (618) 526-8585
Other practice location 3
1052 M L King Dr Ste 2
Centralia, IL 62801-3002
Phone (618) 436-5410
Other providers in O'Fallon, IL
- Sakshi Lakhra
- Bonnie Jean Lampe
- Lifetime Dental Care of Illinois, PC
- Lifetime Dental Care of Illinois, PC
- Mark Lewis Madder
- MDM Healthcare Inc
- Sheri Lynn Miller
- Angela Dion Mitchell
- Natalie Mota
- Ahmed Nadeem
All providers in O'Fallon, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.