IL-IOWA PSYCHIATRY, LLC (NPI# 1053500553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053500553 |
| Entity Type | Organization |
| Organization Name | IL-IOWA PSYCHIATRY, LLC |
| Practice Address |
1634 Avenue of The Cities Moline IL 61265-4860 |
| Practice Telephone | 3097629711 |
| Practice Fax Number | 3097629747 |
| Mailing Telephone | 3097629711 |
| Mailing Fax Number | 3097629747 |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |
| Authorized Official Name | TODD KENT POGUE (PRESIDENT) |
| Authorized Official Telephone | 3097629711 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
1634 AVENUE OF THE CITIES |
| City | MOLINE |
| State | IL |
| Zip Code | 61265-4860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336128933 | Md Anesthesia Services Sc | Anesthesiology | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2006-01-11 |
| 1962973073 | Beth Shelly Physical Therapy LLC | Clinic/Center | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2018-12-16 |
| 1972902062 | Zacariah Shannon | Chiropractor | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2014-08-14 |
| 1780008300 | Liberty Anesthesia & Pain, Inc. | Anesthesiology | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2014-02-18 |
| 1073955977 | Anthony G Conrardy Md Sc | Anesthesiology | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2013-07-22 |
| 1073865291 | Great River Pain Center LLC | Pain Medicine | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2012-10-11 |
| 1457577793 | Quad Cities Wellness and Rehabilitation Center, Ltd. | Chiropractor | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2007-04-17 |
| 1871502245 | Michael James Mcnulty | Chiropractor | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2006-08-05 |
| 1588624514 | Elizabeth R Shelly | Physical Therapist | 1634 Avenue of The Cities, Suite C, Moline, IL 61265-4860 | 2006-03-24 |
| 1861471229 | Sung S Kang | Anesthesiology | 1634 Avenue of The Cities, Moline, IL 61265-4860 | 2006-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982604377 | Dewat R Chaudhry | Psychiatry & Neurology | 616 35th Ave, Suite 3, Moline, IL 61265-6158 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144851684 | Greywood Health Center LLC | Psychiatry & Neurology | 303 W Institute Pl Fl 3, Chicago, IL 60610-3080 | 2020-02-03 |
| 1285273540 | Tms Clinical Services Pllc | Psychiatry & Neurology | 1100 Jorie Blvd Ste 172, Oak Brook, IL 60523-4409 | 2020-01-03 |
| 1942702386 | Brain and Wellness Institute LLC | Psychiatry & Neurology | 30 W Oak St Apt 14a, Chicago, IL 60610-8724 | 2018-03-01 |
| 1598278749 | Elemental Treatment Center Ltd | Psychiatry & Neurology | 612 S Western Ave Apt 1, Chicago, IL 60612-4682 | 2017-11-09 |
| 1225404551 | Family Renewed, LLC | Psychiatry & Neurology | 1004 Pebble Beach Dr, Caseyville, IL 62232-2834 | 2015-08-21 |
| 1487032082 | Jerry Francisco Benzl | Psychiatry & Neurology | 1740 Taylor St., Chicago, IL 60612 | 2015-05-14 |
| 1942697800 | Dr Mo S.c | Psychiatry & Neurology | 2131 W Silverleaf Ln, Addison, IL 60101-6404 | 2015-04-17 |
| 1104234046 | Hitekshya Nepal | Psychiatry & Neurology | 5230 6th Street Frontage Rd E, Springfield, IL 62703-5128 | 2014-07-23 |
| 1740558261 | Jyoti Shah | Psychiatry & Neurology | 1335 N Mill St Ste 100, Naperville, IL 60563-2047 | 2011-12-12 |
| 1083921530 | Jodi Chase | Psychiatry & Neurology | 480 Elm Pl Ste 106, Highland Park, IL 60035-2535 | 2010-09-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.