Provider Demographics
NPI:1881893253
Name:QUAD CITIES INFECTIOUS DISEASES, LLC
Entity type:Organization
Organization Name:QUAD CITIES INFECTIOUS DISEASES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:563-271-4846
Mailing Address - Street 1:3385 DEXTER CT STE 140
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3471
Mailing Address - Country:US
Mailing Address - Phone:563-344-6600
Mailing Address - Fax:
Practice Address - Street 1:3385 DEXTER CT STE 140
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3471
Practice Address - Country:US
Practice Address - Phone:563-344-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty