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Contact Information

SSM CARDINAL GLENNON CHILDRENS HOSPITAL
1 SAINT ELIZABETH BLVD
O'FALLON, IL62269-1099
 Phone: 618-234-2120
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Body Imaging

2085B0100X
 

Cytopathology

207ZC0500X 22 Physician/Pathology
 

Obesity Medicine

2080B0002X 37 Physician/Pediatric Medicine
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for SSM CARDINAL GLENNON CHILDRENS HOSPITAL · (Female)

NPI # 1174577670
Status Active
Credentials
Entity Individual
Enumeration date 05/19/2006
Last updated 09/30/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO Medicaid 540155801
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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