Healthcare Provider Details

I. General information

NPI: 1336381730
Provider Name (Legal Business Name): CHAND PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10420 OLD OLIVE STREET RD SUITE 205
SAINT LOUIS MO
63141-5914
US

IV. Provider business mailing address

10420 OLD OLIVE STREET RD SUITE 205
SAINT LOUIS MO
63141-5914
US

V. Phone/Fax

Practice location:
  • Phone: 314-692-8516
  • Fax:
Mailing address:
  • Phone: 314-692-8516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2008016006
License Number StateMO

VIII. Authorized Official

Name: DR. DEEPALI G. CHAND
Title or Position: OWNER
Credential: M.D.
Phone: 314-504-4698