Short, Nancy J
Short, Nancy J is an sole proprietor health care provider with primary practice located at 4360 Kennedy Dr Suite 1, East Moline IL 61244-4287. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Short, Nancy J can be contacted via phone (309) 743-7313.Contact Information
Primary practice address
4360 Kennedy Dr Suite 1
East Moline IL 61244-4287
Phone: (309) 743-7313
Fax: (309) 765-7999
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036103076 | Illinois |
Profile Details
| NPI number | 1134125032 |
|---|---|
| LBN Legal business name | Short, Nancy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Nov 18th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134125032 | NPPES |
| Other | 151651 | IOWA HEALTH SOLUTIONS | |
| Other | 059704 | IOWA HEALTH SOLUTIONS | |
| MEDICAID | 036103076 | IOWA HEALTH SOLUTIONS | |
| Other | IL01F5 | IOWA HEALTH SOLUTIONS |
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