Provider Demographics
NPI:1912719832
Name:QUAD CITIES WELLNESS CLINIC
Entity type:Organization
Organization Name:QUAD CITIES WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KURANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-650-7135
Mailing Address - Street 1:4350 7TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6870
Mailing Address - Country:US
Mailing Address - Phone:309-517-1180
Mailing Address - Fax:309-517-1113
Practice Address - Street 1:4350 7TH ST STE B
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6870
Practice Address - Country:US
Practice Address - Phone:309-517-1180
Practice Address - Fax:309-517-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty