DR. CHRISTELLE MARLYSE ILBOUDO (NPI# 1083849871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083849871 |
| Entity Type | Individual |
| Full Name | DR. CHRISTELLE MARLYSE ILBOUDO |
| Credential | M.D. |
| Practice Address |
404 N Keene St Columbia MO 65201-6626 |
| Mailing Address |
Po Box 843966 Kansas City MO 64184-3966 |
| Practice Telephone | 5738826921 |
| Mailing Telephone | 5738823974 |
| Mailing Fax Number | 5738840943 |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2018-01-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
2012011809 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2401 Gillham Rd, Kansas City, MO 641084619 | 8162343061 | 8163461328 |
| Street Address |
404 N KEENE ST |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-6626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861486151 | Curators of The University of Missouri | General Acute Care Hospital | 404 N Keene St, Columbia, MO 65201 | 2005-09-01 |
| 1609474493 | Cameron Bishop Taylor | Pharmacist | 404 N Keene St, Columbia, MO 65201-6626 | 2020-10-13 |
| 1265039218 | Pulcherie Guissou Ada | Internal Medicine | 404 N Keene St, Columbia, MO 65201-6626 | 2020-10-02 |
| 1477161529 | Rachel R Couch | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-07-15 |
| 1801414552 | Shruti Sinha | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-07-09 |
| 1699393355 | Kathryn A Guymon | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-07-09 |
| 1578181228 | Nicole L Meyer | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-07-09 |
| 1942827399 | Varun Manohara | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-07-01 |
| 1205453651 | Elly A Ranum | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-07-01 |
| 1710500392 | Shreeya Chugh | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
| Find all providers in zip 65201 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285678078 | Prisma Health Medical Group-midlands | Pediatrics | 9 Richland Medical Park Dr Ste 410, Columbia, SC 29203-6859 | 2006-06-15 |
| 1932698511 | Palmetto Health - University of South Carolina Medical Group | Pediatrics | 9 Richland Medical Park Dr Ste 210, Columbia, SC 29203-6859 | 2018-05-09 |
| 1194761577 | George Stephen Kotchmar Jr. | Pediatrics | 9 Medical Park Rd, Suite 210, Columbia, SC 29203-6873 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487781597 | Tessa Gardner | Pediatrics | 7905 Blackberry Ave, Saint Louis, MO 63130-2710 | 2007-02-27 |
| 1295885580 | Edwin Lemuel Anderson | Pediatrics | 1100 S Grand Blvd Fl 1, Saint Louis, MO 63104-1015 | 2007-01-11 |
| 1518274489 | Mercy Clinic Children's Infectious Disease, LLC | Pediatrics | 621 S New Ballas Rd, Suite 674-a, Saint Louis, MO 63141-8232 | 2010-09-13 |
| 1184936437 | Liset Carla Olarte Carhuaz | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2010-07-01 |
| 1922249739 | Barbara Angelica Pahud | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2009-03-09 |
| 1457507832 | Jennifer Schuster | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-08-17 |
| 1013172055 | Rana El Feghaly | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-07-18 |
| 1427277110 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1285656322 | Russell J Osguthorpe | Pediatrics | 1 Childrens Pl, Suite C, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1730106238 | Patrick C Seed | Pediatrics | 1 Childrens Pl, Suite C, Saint Louis, MO 63110-1002 | 2006-07-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.