Unknown Individual – Family Medicine Physician, NPI 1508854753
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1315, Lehmen Drive, Chester, Randolph County, Illinois, 62233, United States
CHESTER, IL 622330031
Phone: (618) 826-4571
Fax: (618) 826-3229
Type: Location
Ladue Manor, Ladue, Saint Louis County, Missouri, United States
SAINT LOUIS, MO 631241822
Phone: (314) 997-0010
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62233)
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