Organization
KIDNEY CARE QUAD CITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA LOPEZ (OFFICE MANAGER)
(309) 756-6880
Entity
Organization
Contact information
Practice address
615 35TH AVE, MOLINE, IL 61265-6107
(309) 757-7780
(309) 757-7719
Mailing address
615 35TH AVE, MOLINE, IL 61265-6107
(309) 757-7783
(309) 757-7719
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036088655
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720227994
NPI
KS
Enumeration date
02/11/2009
Last updated
01/15/2021
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