QUAD CITY PROSTHETIC INC (NPI# 1194058123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194058123 |
| Entity Type | Organization |
| Organization Name | QUAD CITY PROSTHETIC INC |
| Practice Address |
520 Valley View Dr Ste 500 Moline IL 61265 |
| Mailing Address |
741 W Main St Peoria IL 61606-1953 |
| Practice Telephone | 3097626435 |
| Practice Fax Number | 3092770042 |
| Mailing Telephone | 8003345705 |
| Mailing Fax Number | 8886636322 |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | MR. DONALD GOERTZEN (PRESIDENT) |
| Authorized Official Telephone | 3096762276 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | Y |
| Parent Organization Name | QUAD CITY PROSTHETIC INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952634982 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1222 Shooting Park Rd, #104, Peru, IL 61354 | 2009-09-09 |
| 1578794624 | Quad City Prosthetic Inc | Durable Medical Equipment & Medical Supplies | 2207 E 52nd St, Ste 1, Davenport, IA 52807 | 2009-08-06 |
| 1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
| 1215925805 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 4730 44th St, Rock Island, IL 61201 | 2005-10-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | QUAD CITY PROSTHETIC INC. | 741 West Main Street, Peoria, IL 61606 |
| Street Address |
520 VALLEY VIEW DR STE 500 |
| City | MOLINE |
| State | IL |
| Zip Code | 61265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369419 | Edward A Connolly | Orthopaedic Surgery | 520 Valley View Dr, Moline, IL 61265-6194 | 2006-01-04 |
| 1306476445 | Lauren Emily Haas | Physician Assistant | 520 Valley View Dr, Moline, IL 61265-6152 | 2020-01-16 |
| 1548621774 | Dana Jo Taylor | Specialist/Technologist | 520 Valley View Dr, Ste. 500, Moline, IL 61265-6152 | 2016-03-16 |
| 1669862264 | Alison Vandegrift | Physical Therapist | 520 Valley View Dr, Moline, IL 61265-6152 | 2015-02-03 |
| 1649670332 | Katherine O'day | Occupational Therapist | 520 Valley View Dr, Moline, IL 61265-6152 | 2014-08-29 |
| 1245648963 | Jamie Porter | Physician Assistant | 520 Valley View Dr, Moline, IL 61265-6194 | 2014-07-25 |
| 1235550567 | Andrew Abatiell Md Pllc | Anesthesiology | 520 Valley View Dr, Moline, IL 61265-6152 | 2014-01-06 |
| 1679823223 | Allison M Mcgraw | Occupational Therapist | 520 Valley View Dr, Ste. 200, Moline, IL 61265-6152 | 2012-09-11 |
| 1073882858 | Ashley M Schurr | Physical Therapist | 520 Valley View Dr, Suite 200, Moline, IL 61265-6152 | 2011-12-22 |
| 1487922738 | Andrea M Black | Physician Assistant | 520 Valley View Dr, Moline, IL 61265-6194 | 2011-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649516311 | American Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 515 Valley View Dr, Ste 101, Moline, IL 61265-6175 | 2012-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
| 1225653686 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1290 W Northwest Hwy, Palatine, IL 60067-1897 | 2020-06-11 |
| 1710508239 | Vivian Danielle Williams | Prosthetic/Orthotic Supplier | 940 N Monticello Ave # 1, Chicago, IL 60651-3949 | 2020-05-06 |
| 1265053136 | Dfined Beauty LLC | Prosthetic/Orthotic Supplier | 1507 E 53rd St # 835, Chicago, IL 60615-4573 | 2020-05-02 |
| 1134748767 | The Weave Luxe Bar | Prosthetic/Orthotic Supplier | 7315 Lemont Rd, Downers Grove, IL 60516-3807 | 2020-04-14 |
| 1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
| 1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
| 1164080743 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 391 Quadrangle Dr Ste N4, Bolingbrook, IL 60440-3443 | 2019-05-30 |
| 1760047583 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 13500 Circle Dr Ste 202, Orland Park, IL 60462-1343 | 2019-05-07 |
| 1114580107 | Thomas Gavin | Prosthetic/Orthotic Supplier | 1010 Jorie Blvd Ste 24, Oak Brook, IL 60523-4450 | 2019-04-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.