Quad Cities Kidney Center, LTD.

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

QUAD CITIES KIDNEY CENTER, LTD.

Practice address

400 John Deere Rd
Moline, IL 61265-6898

Phone

(309) 762-5570

Fax

(309) 762-5297

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Rajesh Alla, M.D.

Title

Medical Director

Phone

(309) 762-5570

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1306845409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 JOHN DEERE RD",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656898",
            "telephone_number": "309-762-5570",
            "fax_number": "309-762-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHN DEERE RD",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656898",
            "telephone_number": "309-762-5570",
            "fax_number": "309-762-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITIES KIDNEY CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "ALLA",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-762-5570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA MEDICAID",
            "identifier": "0736447",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK/ BCBS OF IOWA",
            "identifier": "99714",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC-PROVIDER NUMBER",
            "identifier": "675",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• QC OBGYN Associates SC
• QC Wellness Center, LLC
• Quad Cities Autism Center Inc.
• Quad Cities Eye Care, LLC
• Quad Cities Intervention Services
• Quad Cities Mental Health
• Quad Cities Nephrology Associates, P.L.C., LLC
• Quad Cities Pathologists, LLC
• Quad Cities Recovery & Counseling Center LLC
• Quad Cities Regenerative Medicine, LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Moline, IL
• Providers in Moline, IL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.