Provider Demographics
NPI:1780655936
Name:QUINBY, GARY E (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:E
Last Name:QUINBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:600 JOHN DEERE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6869
Mailing Address - Country:US
Mailing Address - Phone:309-779-4200
Mailing Address - Fax:309-779-4305
Practice Address - Street 1:600 JOHN DEERE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6869
Practice Address - Country:US
Practice Address - Phone:309-779-4200
Practice Address - Fax:309-779-4305
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036102180207N00000X, 207ND0101X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070014612OtherRR MEDICARE
IL036102180Medicaid
IL036102180Medicaid
ILH13400Medicare UPIN