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Organization
QUALITY LIFE PROVIDERS LLC
Active
Organization
QUALITY LIFE PROVIDERS LLC
Active
Other names
Quality Life Providers, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES PAUL HARPER LNHA, MBA (CHIEF ADMINISTRATOR)
(847) 980-6325
Entity
Organization
Contact information
Practice address
4166 BLANCHAN AVE, BROOKFIELD, IL 60513-1802
(847) 980-6325
(708) 387-2348
Mailing address
4166 BLANCHAN AVE, BROOKFIELD, IL 60513-1802
(847) 980-6325
(708) 387-2348
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
209002055
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209002055
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P52930
—
IL
Enumeration date
11/05/2010
Last updated
06/07/2011
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