QUALITY LIFE PROVIDERS LLC NPI 1538460670

NPI Information

NPI: 1538460670
Provider Name: QUALITY LIFE PROVIDERS LLC

Other Name: QUALITY LIFE PROVIDERS, LLC

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
4166 BLANCHAN AVE
BROOKFIELD, IL
ZIP 60513
Phone: (847) 980-6325
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QUALITY LIFE PROVIDERS LLC is a psychiatric/mental health nurse practitioner in Brookfield, IL. QUALITY LIFE PROVIDERS LLC NPI is 1538460670. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Quality Life Providers, Llc.

The provider's business location address is:

4166 BLANCHAN AVE
BROOKFIELD, IL
ZIP 60513-802
Phone: (847) 980-6325
Fax: (708) 387-2348

The provider's authorized official is Charles Paul Harper .
The authorized official title is Chief Administrator and has the following contact phone number (847) 980-6325.

The enumeration date for this NPI number is 11/5/2010 and was last updated on 6/7/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	209002055	ILLINOIS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209002055	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	201008	MEDICARE PIN	ILLINOIS
2	P52930	MEDICAID	ILLINOIS
3	P52930	MEDICARE UPIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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