Provider Demographics
NPI:1174567903
Name:FAMILY CARE PARTNERS OF THE QUAD CITIES, P.C.
Entity type:Organization
Organization Name:FAMILY CARE PARTNERS OF THE QUAD CITIES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:GEICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-344-7400
Mailing Address - Street 1:3740 UTICA RIDGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1657
Mailing Address - Country:US
Mailing Address - Phone:563-344-7400
Mailing Address - Fax:563-359-9395
Practice Address - Street 1:3740 UTICA RIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1657
Practice Address - Country:US
Practice Address - Phone:563-344-7400
Practice Address - Fax:563-359-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060-006842207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CG5785OtherMEDICARE RAILROAD
IA40801OtherBLUE CROSS BLUE SHIELD
CH0619OtherMEDICARE RAILROAD
IA0283911Medicaid
DB5028OtherMEDICARE RAILROAD
IL8122900OtherBLUE CROSS BLUE SHIELD
CG5785OtherMEDICARE RAILROAD
DB5028OtherMEDICARE RAILROAD
IL1277890001Medicare NSC