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Organization
QUAD CITY RHEUMATOLOGY SC
Active
Organization
QUAD CITY RHEUMATOLOGY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL F MINITER MD (MD)
(309) 793-3400
Entity
Organization
Contact information
Practice address
2202 18TH AVE, ROCK ISLAND, IL 61201-3614
(309) 762-3400
(309) 764-3878
Mailing address
2202 18TH AVE, ROCK ISLAND, IL 61201-3614
(309) 793-3400
(309) 793-7323
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
NULL
207RR0500X
Rheumatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081977
—
IL
01
—
208506
MEDICARE ID#
IL
Enumeration date
05/30/2006
Last updated
02/04/2009
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