Provider Demographics
NPI:1730237504
Name:QUAID, JEANNE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:MARIE
Last Name:QUAID
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 W EXCHANGE ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-2054
Mailing Address - Country:US
Mailing Address - Phone:708-672-6477
Mailing Address - Fax:708-672-3902
Practice Address - Street 1:722 W EXCHANGE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-2054
Practice Address - Country:US
Practice Address - Phone:708-672-6477
Practice Address - Fax:708-672-3902
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622133OtherBCBS
IL01622133OtherBCBS