Organization Active NPI

Travelwell LLC

  • Health Service Clinic/Center
  • Moline, IL
National Provider Identifier
1053518787
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
36096406 Issued in IL
Legal business name
TRAVELWELL LLC
Practice address
515 Valley View Dr
Suite 103
Moline, IL 61265-6175
Phone
(309) 757-1252
Fax
(309) 757-7398
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tracey I McLoone, MD
Title
Medical Director
Phone
(309) 757-1252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 36096406 IL Primary

Addresses

Primary practice location

515 Valley View Dr
Suite 103
Moline, IL 61265-6175

Mailing address

515 Valley View Dr
Suite 103
Moline, IL 61265-6175
Phone (309) 757-1252

Other names 1

  • PASSPORT HEALTH OF MOLINE Doing business as

National Provider Directory

National Provider Directory

Locations

515 Valley View Dr
Ste 103
Moline, IL 61265
Phone (309) 757-1252

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053518787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 VALLEY VIEW DR",
            "address_2": "SUITE 103",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656175",
            "telephone_number": "309-757-1252",
            "fax_number": "309-757-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 VALLEY VIEW DR",
            "address_2": "SUITE 103",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656175",
            "telephone_number": "309-757-1252",
            "fax_number": "309-757-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVELWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCLOONE",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-757-1252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "36096406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PASSPORT HEALTH OF MOLINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.