MEDICARE: WASHINGTON UNIVERSITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1942710991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON UNIVERSITY

Provider Business Mailing Address
First Line	:	PO BOX 7412011
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-2011
Country	:	US
Telephone Number	:	314-859-1234
Fax Number	:	314-859-1235

Provider Business Practice Location Address
First Line	:	272 MAYFAIR PLAZA SHOPPING CTR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-8009
Country	:	US
Telephone Number	:	314-859-1234
Fax Number	:	314-859-1235

Authorized Official
Title or Position	:	SENIOR DIRECTOR MANAGED CARE
Name	:	CATHY EGHIGIAN
Credential	:
Telephone Number	:	314-273-0770

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	04/25/2025

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Directions to “WASHINGTON UNIVERSITY ” Practice Location

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