MEDICARE: ANTHONY HILL KWAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	036094456	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00053774	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	96232	OTHER	BCWELLMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	036094456	OTHER	BCILLINOIS
4	4057E3	OTHER	JOHN DEERE
5	362739299030	OTHER	TRICARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801860861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY HILL KWAN MD

Provider Business Mailing Address
First Line	:	2570 24TH ST
Second Line	:	STE124
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-5394
Country	:	US
Telephone Number	:	309-779-3670
Fax Number	:	309-779-3675

Provider Business Practice Location Address
First Line	:	2570 24TH ST
Second Line	:	STE124
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-5394
Country	:	US
Telephone Number	:	309-779-3670
Fax Number	:	309-779-3675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	02/05/2015

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