JACOB QUINN (NPI# 1750998704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750998704 |
| Entity Type | Individual |
| Full Name | JACOB QUINN |
| Credential | ATC |
| Practice Address |
1009 Wellington Dr Washington IL 61571-1378 |
| Practice Telephone | 3096482399 |
| Mailing Telephone | 3096482399 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
096004052 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1009 WELLINGTON DR |
| City | WASHINGTON |
| State | IL |
| Zip Code | 61571-1378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904504 | Kelly Hornberger | Physical Therapist | 1201 Newcastle Rd., Washington, IL 61571 | 2018-09-01 |
| 1073050407 | Jillyn Cross | Occupational Therapist | 14 Oxford Court, Washington, IL 61571 | 2017-01-24 |
| 1639410772 | Stephen L Dejaynes | Counselor | 100 Hillcrest Drive, Washington, IL 61571 | 2013-03-14 |
| 1184998692 | One Counseling and Wellness | Counselor | 1003 North Cummings Lane, Washington, IL 61571 | 2012-03-01 |
| 1871878371 | M Lisa Kim | Pharmacist | 1700 Saddleridge Ct, Washington, IL 61571 | 2011-10-15 |
| 1073805156 | Skill Sprout International | Behavioral Analyst | 102 Walnut Street, Washington, IL 61571 | 2011-05-09 |
| 1659600948 | Skill Sprout, LLC | Behavioral Analyst | 128 Washington Square, Washington, IL 61571 | 2009-12-15 |
| 1700024916 | Julie Adams | Developmental Therapist | 700 S. Elm, Washington, IL 61571 | 2009-01-26 |
| 1851595128 | Michael John Herman | Dentist | 106 So Cummings Lane, Washington, IL 61571 | 2007-06-12 |
| 1861539132 | Gary Lee Cunningham | Dentist | 5 Laurel Ct., Washington, IL 61571 | 2007-01-30 |
| Find all providers in zip 61571 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265997951 | Corey Katheleen Carlson | Preventive Medicine | 12576 Lee Hwy, Washington, VA 22747-1928 | 2019-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760987515 | Eric Raul Simental | Preventive Medicine | 1014 Claim St, Aurora, IL 60505 | 2018-03-26 |
| 1043715899 | Ryan Lee Basden | Preventive Medicine | 347 S Gladstone Ave, Aurora, IL 60506-4877 | 2018-03-26 |
| 1639530603 | Sidney Dreyer | Preventive Medicine | 1920 Football Dr, Lake Forest, IL 60045-4829 | 2016-03-17 |
| 1861445256 | Robert J Strugala | Preventive Medicine | 2850 S Wabash Ave, Suite 100, Chicago, IL 60616-2955 | 2006-05-18 |
| City | WASHINGTON |
| Zip Code | 61571 |
Please comment or provide details below to improve the information on JACOB QUINN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.