Garrett Leonard Quail II, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.002378 Issued in IL

Practice address

4555 211TH St
Matteson, IL 60443-2318

Phone

(708) 283-0021

Fax

(708) 283-0831

NPI assigned

Oct 30, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1770762346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 HARVEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023832",
            "telephone_number": "708-917-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 211TH ST",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432318",
            "telephone_number": "708-283-0021",
            "fax_number": "708-283-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAIL",
        "first_name": "GARRETT",
        "middle_name": "LEONARD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.002378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Matteson, IL
• Providers in Matteson, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.