Organization
BRIAN J ANSEEUW M.D. S.C.
Active
Other names
Quad CIty Neurolgy and Spine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JAY ANSEEUW M.D. (OWNER)
(309) 764-4729
Entity
Organization
Contact information
Practice address
616 35TH AVE, UNIT 2, MOLINE, IL 61265-5925
(309) 764-4729
(309) 764-7144
Mailing address
616 35TH AVE, SUITE 2, MOLINE, IL 61265-6158
(309) 764-4729
(309) 764-7144
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
042618374
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102718 2
—
IL
01
—
08126230
BCBS
IL
01
—
94420
WELLMARK
IA
Enumeration date
08/14/2007
Last updated
10/03/2013
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