Provider Demographics
NPI:1427294768
Name:NEOCARE OF THE QUAD CITIES
Entity type:Organization
Organization Name:NEOCARE OF THE QUAD CITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLED
Authorized Official - Middle Name:
Authorized Official - Last Name:IZQUIERDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-736-4170
Mailing Address - Street 1:2066 SOLUTIONS CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-2000
Mailing Address - Country:US
Mailing Address - Phone:309-736-4170
Mailing Address - Fax:309-736-5079
Practice Address - Street 1:2066 SOLUTIONS CTR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60677-2000
Practice Address - Country:US
Practice Address - Phone:309-736-4170
Practice Address - Fax:309-736-5079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036068081174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08119960OtherBCBS