Venkateswararao Alla, M.D.
Individual provider Active NPI Nephrology Physician · Moline, IL
NPI 1669476339 · NPPES record last updated Jun 21, 2016
Key facts
- NPI
- 1669476339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 036056049 (IL)
- Practice address
- 400 John Deere Rd BLDG 1
Moline, IL 61265-6898 - Phone
- (309) 517-3036
- Fax
- (309) 797-1088
- NPI assigned
- Jun 9, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quad Cities Kidney Center Rock Island, LLC | Past |
Accepting new patients | |
| Quad Cities Kidney Center, LTD. | Past |
Accepting new patients | |
| Muscatine Kidney Center, LLC | Past |
Accepting new patients | |
| Dixon Dialysis Center, LLC | Past |
Accepting new patients | |
| Midwest Nephrology Group, LLC | Nephrology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 036056049 | IL | Yes |
Addresses
Primary practice location
400 John Deere Rd BLDG 1
Moline, IL 61265-6898
Mailing address
400 John Deere Rd
BLDG 1
Moline, IL 61265-6898
Phone (309) 517-3036
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0175471 | Other | IA | IA PUBLIC AID GP IA POS |
| 05232009 | Other | IL | BLUE CROSS BLUE SHIELD |
| 0904573 | Other | IA | PUBLIC AID |
| 1669476339 | Other | NPI | |
| 99236 | Other | IL | WELLMARK |
| 0510917 | Other | IL | IA PUBLIC AID GROUP IL PO |
| 56266 | Other | IA | WELLMARK |
| 036056049 | Medicaid | IL | |
| 08100343 | Other | IL | BLUE CROSS BLUE SHIELD |
| 1740349034 | Other | GROUP NPI | |
| 1904573 | Other | IL | PUBLIC AID IA |
| 55646 | Other | IA | WELLMARK |
| 93122 | Other | IL | WELLMARK |
Other providers in Moline, IL
- Alignmed Medical Group Il SC
- Himabindu Alla
- Nandita Alla
- Rajesh Alla
- Suresh Alla
- Angela Mecagni Allen
- Lawrence W Allen
- Melinda Sue Allison
- Allure of the Quad Cities, LLC
- Stacy L. Almanza
All providers in Moline, IL · Nephrology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.