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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