Healthcare Provider Details

I. General information

NPI: 1851035083
Provider Name (Legal Business Name): ELI LYNN PRATTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 CLARKSON RD
CHESTERFIELD MO
63017-5065
US

IV. Provider business mailing address

1815 CLARKSON RD
CHESTERFIELD MO
63017-5065
US

V. Phone/Fax

Practice location:
  • Phone: 636-728-0111
  • Fax: 636-728-0093
Mailing address:
  • Phone: 636-728-0111
  • Fax: 636-728-0093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2026028247
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2022020765
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: