Healthcare Provider Details

I. General information

NPI: 1659140275
Provider Name (Legal Business Name): CHILEME U OCHULOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 N TAYLOR AVE
SAINT LOUIS MO
63108-1888
US

IV. Provider business mailing address

536 N TAYLOR AVE
SAINT LOUIS MO
63108-1888
US

V. Phone/Fax

Practice location:
  • Phone: 314-266-8139
  • Fax: 314-783-2085
Mailing address:
  • Phone: 314-266-8139
  • Fax: 314-783-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025051507
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209034560
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: