Healthcare Provider Details

I. General information

NPI: 1104576628
Provider Name (Legal Business Name): BUSRA ERKILINC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 07/06/2026
Certification Date: 03/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL DIV NEUROLOGY MULTIPLE SCLEROSIS, 7TH FL
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-3293
  • Fax: 314-747-1345
Mailing address:
  • Phone: 314-362-3293
  • Fax: 314-747-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2026012087
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: