Individual
DR. HARRY R WALLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 36TH AVENUE, MOLINE, IL 61265
(309) 743-6700
(309) 764-2042
Mailing address
1236 E RUSHOLME ST, SUITE 300, DAVENPORT, IA 52803-2473
(563) 324-2992
(563) 888-0499
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036058715
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058715
—
IL
05
—
0556977
—
IA
01
—
060053307
MEDICARE RAILROAD
—
Enumeration date
01/10/2006
Last updated
07/21/2022
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