Healthcare Provider Details

I. General information

NPI: 1801049895
Provider Name (Legal Business Name): ARTEMIO B CAJIGAL JR. COUNSELOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 15TH AVE
EAST MOLINE IL
61244-2134
US

IV. Provider business mailing address

500 W RIVER DR
DAVENPORT IA
52801-1014
US

V. Phone/Fax

Practice location:
  • Phone: 563-336-3000
  • Fax: 563-336-3212
Mailing address:
  • Phone: 563-336-3000
  • Fax: 563-336-3212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number45657
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number23115
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: