Provider Demographics
NPI:1467632539
Name:FQC MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:FQC MANAGEMENT SERVICES, INC.
Other - Org Name:FAMILY QUICK CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIPP
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:309-740-2647
Mailing Address - Street 1:9031 N ALLEN RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-1536
Mailing Address - Country:US
Mailing Address - Phone:309-740-2647
Mailing Address - Fax:
Practice Address - Street 1:9031 N ALLEN RD
Practice Address - Street 2:SUITE #3
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-1536
Practice Address - Country:US
Practice Address - Phone:309-740-2647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-000507261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care