ELIZABETH H MAYLACK (NPI# 1154687077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154687077 |
| Entity Type | Individual |
| Full Name | ELIZABETH H MAYLACK |
| Credential | D.O. |
| Practice Address |
1551 Wall St Ste 400 Saint Charles MO 63303-3541 |
| Mailing Address |
Po Box 23340 Saint Louis MO 63156-3340 |
| Practice Telephone | 6366697006 |
| Practice Fax Number | 6366697008 |
| Mailing Telephone | 3148511000 |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2020-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2018020904 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036140361 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1551 WALL ST STE 400 |
| City | SAINT CHARLES |
| State | MO |
| Zip Code | 63303-3541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214787 | Michael Frederick | Pharmacist | 2855 Veterans Memorial Parkway, (pharmacy), Saint Charles, MO 63303 | 2020-10-30 |
| 1710525639 | Cheryl Ann O'dell | Pharmacist | Schnucks Pharmacy, 60 Harvester Square, St Charles, MO 63303 | 2019-12-11 |
| 1255821302 | Melinda R Winfield | Nurse Practitioner | 1313 Park Ct, Saint Charles, MO 63303 | 2018-05-15 |
| 1467904839 | Heather Lilledahl | Speech-Language Pathologist | 2800 Old Muegge Road, Saint Charles, MO 63303 | 2016-11-01 |
| 1437608312 | Preferred Family Healthcare | Counselor | 1559 Old S. River Road, St.charles, MO 63303 | 2016-10-03 |
| 1487109146 | Annette Patricia Davenport | Nurse Practitioner | 1551 Wall Street, Logistics Health Inc, Suite 100, Saint Charles, MO 63303 | 2016-08-23 |
| 1053762328 | Sarah Biondo | Speech-Language Pathologist | 7204 Fountainview Circle, Ofallon, MO 63303 | 2016-06-28 |
| 1710331335 | Lindsey Ann Eilers | Counselor | 1570 South Main, Saint Charles, MO 63303 | 2016-04-20 |
| 1174914600 | Jacquelyn Michele Miller | Pharmacy Technician | 3881 Mexico Road, Saint Charles, MO 63303 | 2015-02-05 |
| 1164838132 | Francelle Denise Neal | Counselor | 2480 Executive Dr Ste 111, Saint Charles, MO 63303 | 2014-07-10 |
| Find all providers in zip 63303 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669837993 | St. Charles Family Clinic Pllc | Family Medicine | 611 W Belle Avenue, Saint Charles, MI 48655 | 2015-12-31 |
| 1922408426 | Total Access Urgent Care, PC | Family Medicine | 3871 Mexico Rd, Saint Charles, MO 63303-3042 | 2014-09-03 |
| 1164793360 | George William Pappas | Family Medicine | 525 Tyler Rd Ste J, Saint Charles, IL 60174-3363 | 2012-01-19 |
| 1407940513 | Hemalini Thakkar | Family Medicine | 2015 Dean St, #2, Saint Charles, IL 60174-1577 | 2006-10-03 |
| 1801903463 | Natan Lvovitch Khotianov | Family Medicine | 12 Tristan Ter, Saint Charles, MO 63303-4207 | 2006-08-23 |
| 1639180631 | Ssm Depaul Medical Group, Inc. | Family Medicine | 1821 Sherman Dr, Saint Charles, MO 63303-3984 | 2006-08-11 |
| 1235173378 | Dr. Eischen Clinic, P. C. | Family Medicine | 106 West Main Street, Suite 267, Saint Charles, IA 50240-0267 | 2006-06-16 |
| 1114977725 | Renato Siazon Lee | Family Medicine | 611 W Belle Ave, Saint Charles, MI 48655-1611 | 2006-05-12 |
| 1013981109 | Steven B Livingstone | Family Medicine | 711 Veterans Memorial Pkwy Ste 300, Saint Charles, MO 63303-2106 | 2006-02-15 |
| 1841274909 | Ronald Gonzales Jr. | Family Medicine | 1124 N Saginaw St, Saint Charles, MI 48655-1021 | 2005-12-02 |
| Find all providers in SAINT CHARLES | ||||
| City | SAINT CHARLES |
| Zip Code | 63303 |
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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.