Healthcare Provider Details

I. General information

NPI: 1932648656
Provider Name (Legal Business Name): S THOMAS SEHY DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 06/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 STACEY BURK DR
FLORA IL
62839-3241
US

IV. Provider business mailing address

10430 PAGE AVE
SAINT LOUIS MO
63132-1228
US

V. Phone/Fax

Practice location:
  • Phone: 877-248-3668
  • Fax: 314-423-8824
Mailing address:
  • Phone: 314-423-8811
  • Fax: 314-423-8824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016005192
License Number StateIL

VIII. Authorized Official

Name: DR. STEPHEN THOMAS SEHY
Title or Position: OWNER/ PODIATRIST
Credential: DPM
Phone: 314-423-8811