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General NPI Number Information
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NPI Number | 1720146319
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Entity Type | Organization
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Legal Business Name | CRESCENT COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1690 ELM ST STE 300
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City | DUBUQUE
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State | IA
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Zip | 52001-3679
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Country | US
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Telephone | 563-690-0321
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Fax | 563-557-8488
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Provider Business Mailing Address
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Address Line | 1690 ELM ST STE 300
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City | DUBUQUE
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State | IA
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Zip | 52001-3679
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Country | US
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Telephone | 563-690-2850
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Fax | 563-239-9149
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Authorized Official
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Title or Position | CEO
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Name | CHAD WOLBERS
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Credential |
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Telephone | 563-690-2862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 08349
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A100692
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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