Organization Name: | IL-IOWA PSYCHIATRY, LLC |
NPI Number: | 1053500553 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD KENT POGUE (PRESIDENT) |
Mailing Address: | 1634 Avenue Of The Cities Moline |
State: | IL US |
Postal Code: | 612654860 |
Phone Number: | 3097629711 |
Fax Number: | 3097629747 |
NPI Enumeration Date: | 10/19/2007 |
NPI Last Update Date: | 10/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |