Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Memory Clinic, Illini Campus
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G. ROGERS (VP OF FINANCE / CFO)
(563) 421-6513
Entity
Organization
Contact information
Practice address
855 ILLINI DR, SUITE 202, SILVIS, IL 61282-2907
(309) 281-2630
(309) 281-2639
Mailing address
865 LINCOLN RD, SUITE L10, BETTENDORF, IA 52722-4190
(563) 355-9200
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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