Healthcare Provider Details

I. General information

NPI: 1790802429
Provider Name (Legal Business Name): ELIZABETH REICHERT WILLIAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH REICHERT

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12855 N 40 DR STE 350
SAINT LOUIS MO
63141-8669
US

IV. Provider business mailing address

12855 N. FORTY DR. STE 375
ST. LOUIS MO
63141
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-6071
  • Fax: 314-567-3321
Mailing address:
  • Phone: 314-567-6071
  • Fax: 314-567-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number2009030113
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number036124392
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036.124392
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2009030113
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: