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General NPI Number Information
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NPI Number | 1235000555
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Entity Type | Individual
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Provider Name | SHILOUH CHANDLER LMT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 11777 GRAVOIS RD STE B
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City | SAINT LOUIS
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State | MO
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Zip | 63127-1822
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Country | US
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Telephone | 314-252-0153
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Fax |
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Provider Business Mailing Address
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Address Line | 10303 WINE HILL RD
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City | CHESTER
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State | IL
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Zip | 62233-3307
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227.023873
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2024050343
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License Number State | MO
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