Organization
QUAD CITIES KIDNEY CENTER SILVIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJESH ALLA M.D. (MEDICAL DIRECTOR)
(309) 762-5570
Entity
Organization
Contact information
Practice address
880 CROSSTOWN AVE, SILVIS, IL 61282-1621
(309) 792-3517
(309) 796-3590
Mailing address
400 JOHN DEERE RD, MOLINE, IL 61265-6898
(309) 762-5570
(309) 762-5297
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50464
BCBS OF IL
IL
Enumeration date
08/10/2006
Last updated
08/29/2014
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