Healthcare Provider Details

I. General information

NPI: 1346708211
Provider Name (Legal Business Name): ALAN HOWARD SIEGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 VALLEY VIEW DR
MOLINE IL
61265-6175
US

IV. Provider business mailing address

515 VALLEY VIEW DR
MOLINE IL
61265-6175
US

V. Phone/Fax

Practice location:
  • Phone: 309-624-4945
  • Fax:
Mailing address:
  • Phone: 309-624-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036181432
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: