QUAD CITIES KIDNEY CENTER, LTD. (NPI# 1417956319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417956319 |
| Entity Type | Organization |
| Organization Name | QUAD CITIES KIDNEY CENTER, LTD. |
| Practice Address |
600 N College Ave Suite 150 Geneseo IL 61254-1096 |
| Mailing Address |
400 John Deere Rd Moline IL 61265-6898 |
| Practice Telephone | 3099451787 |
| Practice Fax Number | 3099451986 |
| Mailing Telephone | 3097625570 |
| Mailing Fax Number | 3097625297 |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2014-08-29 |
| Authorized Official Name | DR. RAJESH ALLA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3097625570 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 003 | 05 | |
| IL | BCBS OF IL | 2104 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700885803 | Quad Cities Kidney Center, Ltd. | Clinic/Center | 120 W Locust St, Davenport, IA 52803-2826 | 2005-07-20 |
| 1306845409 | Quad Cities Kidney Center, Ltd. | Clinic/Center | 400 John Deere Rd, Moline, IL 61265-6898 | 2005-07-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | QUAD CITIES KIDNEY CENTER, LTD. | 400 John Deere Rd, Moline, IL 61265 |
| Street Address |
600 N COLLEGE AVE SUITE 150 |
| City | GENESEO |
| State | IL |
| Zip Code | 61254-1096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675733 | Marcella Alene Miner | Nurse Practitioner | 600 N College Ave, Geneseo, IL 61254-1099 | 2020-09-30 |
| 1285278093 | Kailey Nicole Limes | Dietitian, Registered | 600 N College Ave, Geneseo, IL 61254-1099 | 2019-11-05 |
| 1164065801 | Staci Lynne Circello | Nurse Practitioner | 600 N College Ave, Geneseo, IL 61254-1099 | 2019-10-25 |
| 1164926945 | Kristen K Maughan | Dietitian, Registered | 600 N College Ave, Geneseo, IL 61254-1094 | 2018-03-19 |
| 1093213308 | Hammond Henry Dist Hospital | Clinic/Center | 600 N College Ave, Geneseo, IL 61254-1091 | 2018-02-01 |
| 1497207799 | Brittany Courson | Nurse Practitioner | 600 N College Ave, Ste 102, Geneseo, IL 61254-1091 | 2016-11-03 |
| 1821440959 | Kati Grimes | Nurse Practitioner | 600 N College Ave, Ste 120, Geneseo, IL 61254-1091 | 2016-07-13 |
| 1548620909 | Fresenius Medical Care Quad Cities, LLC | Clinic/Center | 600 N College Ave, Suite 150, Geneseo, IL 61254-1091 | 2016-02-29 |
| 1285005850 | Iowa Physicians Clinic Medical Foundation | Physician Assistant | 600 N College Ave, Suite 120, Geneseo, IL 61254-1095 | 2015-10-08 |
| 1053787333 | Iowa Illinois Pain Consultants PC | Clinic/Center | 600 N College Ave, Geneseo, IL 61254-1091 | 2015-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891259362 | Allison J Blade | Nurse Practitioner | 600 N College Avenue Suite 120, Geneseo, IL 61254 | 2019-01-29 |
| 1477070258 | Aaron Thomas Wachtel, Dds | Dentist | 608 E. Ogden Avenue, Geneseo, IL 61254 | 2017-08-23 |
| 1558895722 | Triston Harry | Social Worker | 2707 17th Street, Rock Island, IL 61254 | 2017-04-14 |
| 1306392980 | Rebecca Woodard | Counselor | 2701 17 Street, Rock Island, IL 61254 | 2016-09-01 |
| 1164701082 | Kara Wiedenhoeft | Physical Therapist | 29 Meadowbrook Drive, Geneseo, IL 61254 | 2011-08-09 |
| 1982256301 | Jalyn April Salas | Occupational Therapy Assistant | 704 S Illinois St, Geneseo, IL 61254 | 2019-07-15 |
| 1306318001 | Ashley Mclaughlin | Social Worker | 2701 17th St, Rock Island, IL 61254 | 2018-12-19 |
| 1144747858 | Logan Hagerman | Counselor | 2701 17th St, Rock Island, IL 61254 | 2017-08-23 |
| 1013454677 | Amber Leanne Cozad | Counselor | 2701 17th St, Rock Island, IL 61254 | 2017-01-20 |
| 1457898173 | Paul Schmidt | Counselor | 2701 17th Street, Rock Island, IL 61254 | 2017-01-20 |
| Find all providers in zip 61254 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912175621 | Nicholas H. Noyes Memorial Hospital | Clinic/Center | 4616 Milllenium Dr, Geneseo, NY 14454 | 2008-02-15 |
| 1548620909 | Fresenius Medical Care Quad Cities, LLC | Clinic/Center | 600 N College Ave, Suite 150, Geneseo, IL 61254-1091 | 2016-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550486 | Home Dialysis & Kidney Care Limited | Clinic/Center | 1252 Ogden Ave Ste D, Downers Grove, IL 60515-2740 | 2020-08-28 |
| 1922619824 | Dialysis Care Center Evergreen Park LLC | Clinic/Center | 9834 S Kedzie Ave, Evergreen Park, IL 60805-3135 | 2020-08-13 |
| 1558970525 | Concerto Massachusetts LLC | Clinic/Center | 4600 W Touhy Ave Ste 100, Lincolnwood, IL 60712-1606 | 2020-07-27 |
| 1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
| 1376162735 | Hopkinton Dialysis LLC | Clinic/Center | 6001 W Ogden Ave, Cicero, IL 60804-3739 | 2020-04-15 |
| 1710511399 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1946 Grand Avenue, Granite City, IL 62040-4613 | 2020-02-24 |
| 1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
| 1033741608 | Fresenius Medical Care New Lenox, LLC | Clinic/Center | 662 Cedar Crossings Dr, New Lenox, IL 60451-5200 | 2020-02-11 |
| 1730725904 | Perryton Dialysis LLC | Clinic/Center | 8604 Woodward Ave, Woodridge, IL 60517-3171 | 2019-11-22 |
| 1124678529 | Dialyze Direct Il LLC | Clinic/Center | 410 S Heinlein Dr, Shelbyville, IL 62565-7800 | 2019-09-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on QUAD CITIES KIDNEY CENTER, LTD..
| 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.