Healthcare Provider Details

I. General information

NPI: 1306282405
Provider Name (Legal Business Name): RACHEL K SESTRICH CDR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2013
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12655 OLIVE BLVD 4TH FLOOR
SAINT LOUIS MO
63141-6362
US

IV. Provider business mailing address

PO BOX 419052
SAINT LOUIS MO
63141-9052
US

V. Phone/Fax

Practice location:
  • Phone: 314-851-1000
  • Fax: 314-851-4445
Mailing address:
  • Phone: 314-851-1000
  • Fax: 314-851-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164012204
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2007033599
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: