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10016 Office Center Ave Suite 100 Saint Louis MO 63128-1468 | |
| (314) 720-0855 | |
| (314) 735-4335 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 10016 Office Center Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Tysyn Contreras (DIRECTOR OF QUALITY ASSURANCE) |
| Authorized Official Contact | 7737517200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3319 N Elston Ave Suite 200 Chicago IL 60618-5811 Ph: (773) 751-7200 | 10016 Office Center Ave Suite 100 Saint Louis MO 63128-1468 Ph: (314) 720-0855 |
| NPI Number | 1992057566 |
|---|---|
| Provider Enumeration Date | 10/08/2012 |
| Last Update Date | 10/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992057566 | NPI | - | NPPES |
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