Individual
GRACE QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
316 W BURNETT RD, ISLAND LAKE, IL 60042-9205
(847) 791-1590
Mailing address
316 W BURNETT RD, ISLAND LAKE, IL 60042-9205
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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