Individual
MICHELLE DENISE MCQUILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Contact information
Practice address
321 REGENCY PARK, O'FALLON, IL 62269
(618) 416-7970
(618) 416-7971
Mailing address
210 W. MCKINLEY AVE., SUITE 1, DECATUR, IL 62526
(217) 877-9442
(217) 233-1670
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.021778
IL
363LF0000X
Family Nurse Practitioner
209021778
IL
Other
Enumeration date
06/18/2020
Last updated
12/13/2024
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