Healthcare Provider Details

I. General information

NPI: 1043842735
Provider Name (Legal Business Name): PAPILIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14561 N OUTER 40 RD
CHESTERFIELD MO
63017-5703
US

IV. Provider business mailing address

817 N FOREST AVE
SAINT LOUIS MO
63119-1929
US

V. Phone/Fax

Practice location:
  • Phone: 314-881-4000
  • Fax:
Mailing address:
  • Phone: 314-619-4596
  • Fax: 314-451-5445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CAROL CROOKS
Title or Position: OWNER
Credential: MD
Phone: 314-619-4596