Organization Active NPI

Medical Psychiatry Services LLC

  • Psychiatry Physician
  • Moline, IL
National Provider Identifier
1922087576
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036105933 Issued in IL
Legal business name
MEDICAL PSYCHIATRY SERVICES LLC
Practice address
4350 7TH St Ste D
Moline, IL 61265-6870
Phone
(309) 757-1337
Fax
(309) 757-1339
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Authorized official

Name
Ralph Saintfort, MD
Title
President
Phone
(309) 757-1337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036105933 IL Primary

Addresses

Primary practice location

4350 7TH St Ste D
Moline, IL 61265-6870

Mailing address

4350 7TH St Ste D
Moline, IL 61265-6870
Phone (309) 757-1337

Other identifiers 1

IdentifierTypeStateIssuer
036105933MedicaidIL

National Provider Directory

National Provider Directory

Locations

4350 7th St
Ste D
Moline, IL 61265
Phone (309) 757-1337

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1922087576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 7TH ST STE D",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656870",
            "telephone_number": "309-757-1337",
            "fax_number": "309-757-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 7TH ST STE D",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656870",
            "telephone_number": "309-757-1337",
            "fax_number": "309-757-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PSYCHIATRY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "SAINTFORT",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-757-1337",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036105933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105933",
            "state": "IL"
        }
    ],
    "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 Apr 9, 2010; 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.