Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G. ROGERS (VICE PRESIDENT OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
865 LINCOLN RD, SUITE L10, BETTENDORF, IA 52722-4190
(563) 355-9191
(563) 355-3419
Mailing address
865 LINCOLN RD, SUITE L10, BETTENDORF, IA 52722-4190
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IA
207Q00000X
Family Medicine Physician
—
IL
207R00000X
Internal Medicine Physician
—
IA
207R00000X
Internal Medicine Physician
—
IL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
IA
207V00000X
Obstetrics & Gynecology Physician
—
IA
207V00000X
Obstetrics & Gynecology Physician
—
IL
208000000X
Pediatrics Physician
—
IA
208000000X
Pediatrics Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10121664
BC/BS OF IL
IL
01
—
90000625
BC/BS OF IL
IL
Enumeration date
01/18/2006
Last updated
04/20/2017
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