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Individual

ADAM M QUINN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5409 N KNOXVILLE AVE, PEORIA, IL 61614-5069
(309) 683-6152
Mailing address
PO BOX 60070, N CHARLESTON, SC 29419-0070
(866) 759-4528

Taxonomy

Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
OS014665
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036.111130
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
OS014665
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0361111301
IL
Enumeration date
04/18/2007
Last updated
08/13/2012
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