Healthcare Provider Details

I. General information

NPI: 1376288050
Provider Name (Legal Business Name): RSC ILLINOIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 7TH ST
MOLINE IL
61265-6867
US

IV. Provider business mailing address

401 COMMERCE ST STE 600
NASHVILLE TN
37219-2518
US

V. Phone/Fax

Practice location:
  • Phone: 397-625-5560
  • Fax:
Mailing address:
  • Phone: 615-345-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EMILY RAIFORD
Title or Position: DIRECTOR
Credential:
Phone: 615-760-6588