Healthcare Provider Details

I. General information

NPI: 1942380605
Provider Name (Legal Business Name): GASTROINTESTINAL CLINIC OF QUAD CITIES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 UTICA RIDGE RD SUITE 100
DAVENPORT IA
52807-3480
US

IV. Provider business mailing address

545 VALLEY VIEW DR STE 100
MOLINE IL
61265-6138
US

V. Phone/Fax

Practice location:
  • Phone: 563-359-9696
  • Fax: 563-359-1730
Mailing address:
  • Phone: 309-762-5560
  • Fax: 309-277-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMITKUMAR PATEL
Title or Position: OWENR
Credential: MD
Phone: 309-762-9711