Healthcare Provider Details

I. General information

NPI: 1700365707
Provider Name (Legal Business Name): TELEMEDICO PHYSICIANS OF MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 BOLIVAR ST
JEFFERSON CITY MO
65101-1572
US

IV. Provider business mailing address

PO BOX 1541
NORTHBROOK IL
60065-1541
US

V. Phone/Fax

Practice location:
  • Phone: 847-386-7744
  • Fax:
Mailing address:
  • Phone: 866-227-3606
  • Fax: 773-439-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2016014256
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JOEL C OKNER
Title or Position: PRESIDENT
Credential: MD
Phone: 866-227-3606