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General NPI Number Information
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NPI Number | 1447433859
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Entity Type | Organization
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Legal Business Name | GENERATIONS WOMENS HEALTH S C
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 612 - 35TH AVENUE
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City | MOLINE
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State | IL
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Zip | 61265
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Country | US
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Telephone | 309-764-1133
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Fax | 309-764-6769
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Provider Business Mailing Address
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Address Line | 612 - 35TH AVENUE
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City | MOLINE
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State | IL
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Zip | 61265-6176
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Country | US
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Telephone | 309-764-1133
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Fax | 309-764-6769
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Authorized Official
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Title or Position | PROVIDER/CO-OWNER
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Name | RHONDA L. FREED
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Credential | M.D.
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Telephone | 309-764-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 042-005511
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036 099463
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036 100979
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License Number State | IL
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