QUALITY LIFE PROVIDERS LLC


Address: 4166 Blanchan Ave, Brookfield, IL 60513-1802
Phone: 8479806325

QUALITY LIFE PROVIDERS LLC (NPI# 1538460670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538460670
Entity Type Organization
Organization Name QUALITY LIFE PROVIDERS LLC
Other Organization Name QUALITY LIFE PROVIDERS, LLC
Practice Address 4166 Blanchan Ave
Brookfield
IL 60513-1802
Practice Telephone 8479806325
Practice Fax Number 7083872348
Mailing Telephone 8479806325
Mailing Fax Number 7083872348
Enumeration Date 2010-11-05
Last Update Date 2011-06-07
Authorized Official Name CHARLES PAUL HARPER (CHIEF ADMINISTRATOR)
Authorized Official Telephone 8479806325
Authorized Official Credential LNHA, MBA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LG0600X Nurse Practitioner
Specialization: Gerontology
209002055 IL Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
209002055 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL P52930 05

Other Provider/Organization Names

Other Name Type Code
Quality Life Providers, LLC Other Name - Individual/Organization

Office Location

Street Address 4166 BLANCHAN AVE
City BROOKFIELD
State IL
Zip Code 60513-1802

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City BROOKFIELD
Zip Code 60513

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Dataset Information

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.

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