NPIMap

Individual provider Active NPI

Quinn Debose

  • Student in an Organized Health Care Education/Training Program
  • Park Forest, IL
National Provider Identifier
1851713291
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
124 Elm St
Park Forest, IL 60466-1744
Phone
(312) 437-0729
NPI assigned
Jan 18, 2014
Last updated
May 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL Primary

Addresses

Primary practice location

124 Elm St
Park Forest, IL 60466-1744

Mailing address

11111 S Western Ave,
Chicago, IL 60643-1744
Phone (773) 238-1100

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brenda T. Thompson Past Accepting new patients
The Branch Family Institute, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1390003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1851713291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 S WESTERN AVE,",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431744",
            "telephone_number": "773-238-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ELM ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661744",
            "telephone_number": "312-437-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOSE",
        "first_name": "QUINN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-18",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.