Provider Demographics
NPI:1508061987
Name:QC OBGYN ASSOCIATES SC
Entity Type:Organization
Organization Name:QC OBGYN ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:PIMENTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-736-4170
Mailing Address - Street 1:855 ILLINI DR
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-2907
Mailing Address - Country:US
Mailing Address - Phone:309-792-0500
Mailing Address - Fax:
Practice Address - Street 1:600 35TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6145
Practice Address - Country:US
Practice Address - Phone:309-736-4170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty