The Eye Center of the Quad Cities, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036-104091 Issued in IL

Legal business name

THE EYE CENTER OF THE QUAD CITIES, LLC

Practice address

4540 3Rd St
Moline, IL 61265-6104

Phone

(309) 797-0877

Fax

(309) 797-9299

NPI assigned

Apr 23, 2006

Last updated

Aug 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raz Dilip Penmatcha, M.D.

Title

President Ophthalmologist

Phone

(309) 797-0877

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent C Nielsen, O.D.

  • Optometrist
  • Moline, IL
  • NPI 1518078989
  NPD (past)
• Leland David Peterson, OD

  • Optometrist
  • Rock Island, IL
  • NPI 1962608836
  NPD (past)

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

{
    "created_epoch": "1145750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1073579629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656104",
            "telephone_number": "309-797-0877",
            "fax_number": "309-797-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656104",
            "telephone_number": "309-797-0877",
            "fax_number": "309-797-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE CENTER OF THE QUAD CITIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-23",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "PENMATCHA",
        "authorized_official_first_name": "RAZ",
        "authorized_official_middle_name": "DILIP",
        "authorized_official_title_or_position": "PRESIDENT OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "309-797-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-104091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Teslik
• Craig James Thatcher
• The Arc of the Quad Cities Area
• The Association for Retarded Citizens of Rock Island County
• The Center for Neurosciences, LLC
• The Project of the Quad Cities
• The Project of the Quad Cities (Two Rivers Pharmacy)
• The Quad Cities Rehabilitation Institute, LLC (The Quad Cities Rehabilitation Institute)
• The Rem Center
• The Robert Young Center for Community Mental Health (Robert Young Center)

• Ophthalmology Physician in Moline, IL
• Providers in Moline, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.