Healthcare Provider Details

I. General information

NPI: 1114632726
Provider Name (Legal Business Name): USA VEIN CLINICS OF MISSOURI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 N OAK TRAFFICWAY SUITE 201C
KANSAS CITY MO
64155-2201
US

IV. Provider business mailing address

PO BOX 1602
NORTHBROOK IL
60065-1602
US

V. Phone/Fax

Practice location:
  • Phone: 816-436-7373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: FLORA KATSNELSON
Title or Position: OWNER
Credential: MD
Phone: 847-593-8460