Provider Demographics
NPI:1871114025
Name:QUICKCARE, PLLC
Entity type:Organization
Organization Name:QUICKCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUEENESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:708-469-8973
Mailing Address - Street 1:6419 W TOUHY AVE APT 4A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-1040
Mailing Address - Country:US
Mailing Address - Phone:708-469-8973
Mailing Address - Fax:
Practice Address - Street 1:6419 W TOUHY AVE APT 4A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-1040
Practice Address - Country:US
Practice Address - Phone:708-469-8973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty