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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

NPI Number 1174577670
LBN Legal business name SSM CARDINAL GLENNON CHILDRENS HOSPITAL
Authorized official KAREN REWERTS - (VP FINANCE)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/19/2006
Last updated 09/30/2020 - About 6 years ago
Identifiers
MO Medicaid 540155801
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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