Healthcare Provider Details

I. General information

NPI: 1548808728
Provider Name (Legal Business Name): UNITYPOINT HEALTH AT WORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3922 16TH ST
MOLINE IL
61265-1275
US

IV. Provider business mailing address

1776 W LAKES PKWY STE 400
WEST DES MOINES IA
50266-8378
US

V. Phone/Fax

Practice location:
  • Phone: 309-765-6200
  • Fax:
Mailing address:
  • Phone: 515-241-5391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SARAH J SULLIVAN
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential:
Phone: 515-241-5391