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NPI Code Detail

MEDICARE: QUAD CITIES KIDNEY CENTER, LTD.

MEDICARE: QUAD CITIES KIDNEY CENTER, LTD.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
299714OTHERIAWELLMARK/ BCBS OF IOWA
3675OTHERILBC-PROVIDER NUMBER

General Provider Information

NPI Number : 1306845409
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUAD CITIES KIDNEY CENTER, LTD.
Provider Business Mailing Address
First Line : 400 JOHN DEERE RD
Second Line :
City : MOLINE
State : IL
Zip : 61265-6898
Country : US
Telephone Number : 309-762-5570
Fax Number : 309-762-5297
Provider Business Practice Location Address
First Line : 400 JOHN DEERE RD
Second Line :
City : MOLINE
State : IL
Zip : 61265-6898
Country : US
Telephone Number : 309-762-5570
Fax Number : 309-762-5297
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. RAJESH ALLA
Credential : M.D.
Telephone Number : 309-762-5570
Provider Enumeration Date : 07/20/2005
Last Update Date : 08/28/2014

Similar Medicare Providers

1730530148 — LEWIS T MANN M.D.
Practice Location Address:
400 JOHN DEERE RD BLDG 2
MOLINE, IL
61265-6898
Practice Phone: 309-517-3036
Practice Fax: 309-797-1088
1881603165 — TRAVIS L FIGANBAUM M.D.
Practice Location Address:
400 JOHN DEERE RD BLDG 2
MOLINE, IL
61265-6898
Practice Phone: 309-517-3036
Practice Fax: 309-797-1088
1669476339 — VENKATESWARARAO ALLA M.D.
Practice Location Address:
400 JOHN DEERE RD BLDG 1
MOLINE, IL
61265-6898
Practice Phone: 309-517-3036
Practice Fax: 309-797-1088
1285739151 — PAMELA S. VIPOND APRN
Practice Location Address:
400 JOHN DEERE RD BLDG 1
MOLINE, IL
61265-6898
Practice Phone: 309-517-3036
Practice Fax: 309-797-1088
1740349034 — QUAD CITIES NEPHROLOGY ASSOCIATES, P.L.C., LLC
Practice Location Address:
400 JOHN DEERE RD BLDG 1
MOLINE, IL
61265-6898
Practice Phone: 309-517-3036
Practice Fax: 309-797-1088
1154462224 — DR. RAJESH ALLA M.D.
Practice Location Address:
400 JOHN DEERE RD BLDG 2
MOLINE, IL
61265-6898
Practice Phone: 309-517-3036
Practice Fax: 309-797-1088

Directions to “QUAD CITIES KIDNEY CENTER, LTD. ” Practice Location

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