Provider Demographics
NPI:1487882106
Name:QUINLAN, MEGAN COLLEEN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:COLLEEN
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:COLLEEN
Other - Last Name:PHELAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:9530 S COOK AVE
Mailing Address - Street 2:UNIT #603
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3176
Mailing Address - Country:US
Mailing Address - Phone:708-606-5560
Mailing Address - Fax:
Practice Address - Street 1:9530 S COOK AVE
Practice Address - Street 2:UNIT #603
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3176
Practice Address - Country:US
Practice Address - Phone:708-606-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009419235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist