Provider Demographics
NPI:1508974304
Name:ARTHRITIS CARE CENTER PC
Entity Type:Organization
Organization Name:ARTHRITIS CARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:USHARANI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:309-762-4500
Mailing Address - Street 1:609 35TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265
Mailing Address - Country:US
Mailing Address - Phone:309-762-4500
Mailing Address - Fax:309-762-4661
Practice Address - Street 1:609 35TH AVENUE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265
Practice Address - Country:US
Practice Address - Phone:309-762-4500
Practice Address - Fax:309-762-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213467Medicare ID - Type Unspecified