1942380605 NPI number — GASTROINTESTINAL CLINIC OF QUAD CITIES, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942380605 NPI number — GASTROINTESTINAL CLINIC OF QUAD CITIES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GASTROINTESTINAL CLINIC OF QUAD CITIES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942380605
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
545 VALLEY VIEW DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOLINE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61265-6138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-762-5560
Provider Business Mailing Address Fax Number:
309-277-1191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5041 UTICA RIDGE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52807-3480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-359-9696
Provider Business Practice Location Address Fax Number:
563-359-1730
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
AMITKUMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
OWENR
Authorized Official Telephone Number:
309-762-9711

Provider Taxonomy Codes

  • Taxonomy code: 2080P0206X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com