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Individual

MR. FREDERICK DOUGLAS QUINN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC, NCC, DAPA

Contact information

Practice address
540 W. FRONTAGE ROAD, SUITE 2115, NORTHFIELD, IL 60093-1291
(847) 337-7846
Mailing address
540 W FRONTAGE RD, SUITE 2115, NORTHFIELD, IL 60093-1250
(847) 337-7846

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180-005700
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060-008928
REGISTERED PROFESSIONAL SERVICE CORP.
IL
01
180-005700
DEPT OF FIN AND PRO. REGULATION
IL
Enumeration date
09/12/2008
Last updated
05/27/2011
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