WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC. (NPI# 1528569845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528569845 |
| Entity Type | Organization |
| Organization Name | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC. |
| Other Organization Name | WUPI - PEDIATRICS |
| Practice Address |
1414 Cross St O Fallon IL 62269-2988 |
| Mailing Address |
4240 Duncan Ave Ste 301 Saint Louis MO 63110-1123 |
| Practice Telephone | 3142861264 |
| Practice Fax Number | 3142861258 |
| Mailing Telephone | 3142730770 |
| Mailing Fax Number | 3142730470 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-26 |
| Authorized Official Name | CATHY EGHIGIAN (DIRECTOR, CREDENTIALING) |
| Authorized Official Telephone | 3142730770 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WUPI - Pediatrics | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700374105 | Washington University Physicians In Illinois, Inc. | Clinic/Center | 1414 Cross St, Shiloh, IL 62269-2988 | 2018-05-01 |
| 1639679749 | Washington University Physicians In Illinois, Inc. | Clinic/Center | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2018-02-15 |
| 1811497043 | Washington University Physicians In Illinois, Inc. | Clinic/Center | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2018-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC. | 1414 Cross St, O Fallon, IL 62269-2988 |
| Street Address |
1414 CROSS ST |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-2988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891265039 | Washington University Physicians In Illinois, Inc | Physical Therapist | 1414 Cross St, O Fallon, IL 62269-2988 | 2018-11-30 |
| 1477076263 | Washington University Physicians In Illinois, Inc | Clinic/Center | 1414 Cross St, O Fallon, IL 62269-2988 | 2017-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563000 | Milestones Behavioral Health Services | Clinic/Center | 939 Georgetowne Dr, O Fallon, IL 62269-3414 | 2020-06-18 |
| 1558767244 | Whole Health Medical Group Ohio Professional Corporation | Clinic/Center | 1000 Technology Dr, O Fallon, MO 63368-2239 | 2014-11-07 |
| 1114431616 | New Heights Integrated Health Sc | Clinic/Center | 124 Regency Park Ste 7, O Fallon, IL 62269-1994 | 2017-11-21 |
| 1477076263 | Washington University Physicians In Illinois, Inc | Clinic/Center | 1414 Cross St, O Fallon, IL 62269-2988 | 2017-07-24 |
| 1083958706 | O'fallon Pain Relief Associates LLC | Clinic/Center | 2682 Babble Creek Ln, O Fallon, MO 63368-8337 | 2012-11-19 |
| 1609010859 | Holistic Health & Wellness Sc | Clinic/Center | 4965 Stone Falls Ctr, Suite # 7, O Fallon, IL 62269-7802 | 2009-04-30 |
| 1609942747 | Physician Groups Lc | Clinic/Center | 3449 Pheasant Meadow Dr, Suite 107, O Fallon, MO 63368-7364 | 2006-11-28 |
| 1184731010 | Back & Neck Care Center, P.C. | Clinic/Center | 2682 Babble Creek Ln, O Fallon, MO 63368-8337 | 2006-08-24 |
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| 1104460922 | Infinite Care Home Physicians LLC | Clinic/Center | 6044 N Nassau Ave, Chicago, IL 60631-2649 | 2019-11-05 |
| 1962051607 | Wilkes Post Acute Care Inc | Clinic/Center | 400 W 76th St Ste 303, Chicago, IL 60620-1640 | 2019-09-05 |
| 1114573672 | Immediate Home Care Physicians Services Inc | Clinic/Center | 10516 S Roberts Rd Ste A2, Palos Hills, IL 60465-1934 | 2019-08-12 |
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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.