Active NPI
Al R Doyle, MD
- Psychiatry Physician
- Moline, IL
National Provider Identifier
1710988191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036
- Practice address
- 111 19TH Ave
Moline, IL 61265-3754 - Phone
- (309) 757-0300
- Fax
- (309) 757-0400
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036 | IL | Primary |
Addresses
Primary practice location
111 19TH Ave
Moline, IL 61265-3754
Mailing address
111 19TH Ave
Moline, IL 61265-3754
Phone (309) 757-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0169094 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036 | IL | MD | Hematology (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Health & Wellness Center Inc | Current | Accepting new patients | |
| Vera French Community Mental Health | Past | Accepting new patients | |
| Vera French Community Mental Health | Past | Accepting new patients |
Locations
111 19th Ave
Moline, IL 61265
Phone (309) 757-0300
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Moline, IL
- NPI 1740387927
-
dba Vera French Community Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Davenport, IA
- NPI 1245291129
-
dba Vera French Clinic at Duck Creek
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bettendorf, IA
- NPI 1568239978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1710988191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 19TH AVE",
"city": "MOLINE",
"state": "IL",
"postal_code": "612653754",
"telephone_number": "309-757-0300",
"fax_number": "309-757-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 19TH AVE",
"city": "MOLINE",
"state": "IL",
"postal_code": "612653754",
"telephone_number": "309-757-0300",
"fax_number": "309-757-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOYLE",
"first_name": "AL",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0169094",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
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 Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.