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General NPI Number Information
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NPI Number | 1760412068
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Entity Type | Organization
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Legal Business Name | GENESIS HEALTH SYSTEM
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2526 41ST ST
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City | MOLINE
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State | IL
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Zip | 61265-5016
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Country | US
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Telephone | 309-792-7063
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Fax | 309-764-9326
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Provider Business Mailing Address
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Address Line | 2526 41ST ST
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City | MOLINE
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State | IL
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Zip | 61265-5016
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Country | US
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Telephone | 309-792-7063
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Fax | 309-764-9326
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MR. MARK J. KLEINSCHMIDT
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Credential |
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Telephone | 563-421-6513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071002883
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038007310
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164002086
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085001982
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036062709
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License Number State | IL
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