Healthcare Provider Details

I. General information

NPI: 1881893253
Provider Name (Legal Business Name): QUAD CITIES INFECTIOUS DISEASES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3385 DEXTER CT STE 140
DAVENPORT IA
52807-3471
US

IV. Provider business mailing address

3385 DEXTER CT STE 140
DAVENPORT IA
52807-3471
US

V. Phone/Fax

Practice location:
  • Phone: 563-344-6600
  • Fax:
Mailing address:
  • Phone: 563-344-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNE LOUISE PALUMBO
Title or Position: FOUNDING MEMBER
Credential: D.O.
Phone: 563-271-4846