Individual provider Active NPI

Holly Renee Vanderbol

  • Acute Care Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1841190667
Registry record updated Nov 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209-037084 Issued in IL
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(217) 223-8400
NPI assigned
Nov 6, 2026
Last updated
Nov 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209-037084 IL Primary

Addresses

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

4709 Quail Creek Dr
Quincy, IL 62305-9223
Phone (217) 779-1329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793923200000",
    "number": "1841190667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 QUAIL CREEK DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059223",
            "telephone_number": "217-779-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBOL",
        "first_name": "HOLLY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-11-06",
        "last_updated": "2026-11-06",
        "certification_date": "2026-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209-037084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.