Provider Demographics
NPI:1861164816
Name:HEALTHCARE CONNECT 360 LLC
Entity type:Organization
Organization Name:HEALTHCARE CONNECT 360 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUESADA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:847-345-2441
Mailing Address - Street 1:934 W OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-6646
Mailing Address - Country:US
Mailing Address - Phone:847-644-9317
Mailing Address - Fax:
Practice Address - Street 1:3315 ALGONQUIN RD STE 420C
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3250
Practice Address - Country:US
Practice Address - Phone:847-345-2441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty