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General NPI Number Information
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NPI Number | 1649189283
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Entity Type | Organization
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Legal Business Name | MISSOURI PROFESSIONAL MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 9501 N OAK TRFY
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City | KANSAS CITY
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State | MO
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Zip | 64155-2241
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Country | US
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Telephone | 816-237-5936
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Fax |
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Provider Business Mailing Address
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Address Line | 304 WAINWRIGHT DR STE 120
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City | NORTHBROOK
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State | IL
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Zip | 60062-1919
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Country | US
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Telephone | 847-257-1244
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | YAN KATSNELSON
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Credential | MD
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Telephone | 847-774-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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