Healthcare Provider Details

I. General information

NPI: 1174778047
Provider Name (Legal Business Name): RSC ILLINOIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 VALLEY VIEW DR
MOLINE IL
61265-6138
US

IV. Provider business mailing address

545 VALLEY VIEW DR
MOLINE IL
61265-6138
US

V. Phone/Fax

Practice location:
  • Phone: 309-762-5560
  • Fax: 309-762-7351
Mailing address:
  • Phone: 309-762-5560
  • Fax: 309-762-7351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: JONATHAN BAILEY
Title or Position: OFFICER/AO
Credential:
Phone: 203-609-1168