Healthcare Provider Details

I. General information

NPI: 1407888498
Provider Name (Legal Business Name): XIAOBIN YI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 N BALLAS RD DIV ANES PAIN MGT
SAINT LOUIS MO
63131-2329
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-7200
  • Fax: 314-996-7376
Mailing address:
  • Phone: 314-996-7200
  • Fax: 314-996-7376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2004009999
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2004009999
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: