Active NPI
Mallory K. Quinn, DT
- Specialist
- Chicago, IL
National Provider Identifier
1598893968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MQ15380506P
- Practice address
- 3040 N. Wilton
Chicago, IL 60657 - Phone
- (773) 296-8452
- Fax
- (773) 296-7281
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MQ15380506P | IL | Primary |
Addresses
Primary practice location
3040 N. Wilton
Chicago, IL 60657
Mailing address
10401 S. Sangamon
Chicago, IL 60628
Phone (773) 776-3685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MQ15380506P | Other | IL | EARLY INTERVENTION PROVID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MQ15380506P | IL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598893968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10401 S. SANGAMON",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60628",
"telephone_number": "773-776-3685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 N. WILTON",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60657",
"telephone_number": "773-296-8452",
"fax_number": "773-296-7281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "MALLORY",
"middle_name": "K.",
"name_prefix": "Ms.",
"credential": "DT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "MQ15380506P",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EARLY INTERVENTION PROVID",
"identifier": "MQ15380506P",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.