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NPI Code Detail

MEDICARE: KATHLEEN CIZEK M.D.

MEDICARE: KATHLEEN CIZEK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician105368MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000010012OTHERMOESSENCE
2F62723OTHERMOMERCY
30400467OTHERMOUHC
44412341OTHERMOAETNA
525195OTHERMOBCBS
6127469OTHERMOGHP
7247224OTHERMOHEALTHLINK

General Provider Information

NPI Number : 1083605331
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN CIZEK M.D.
Provider Business Mailing Address
First Line : PO BOX 23340
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63156-3340
Country : US
Telephone Number : 314-843-7333
Fax Number : 314-843-9946
Provider Business Practice Location Address
First Line : 5034 GRIFFIN RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63128-3418
Country : US
Telephone Number : 314-843-7333
Fax Number : 314-843-9946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 09/21/2012

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Directions to “ KATHLEEN CIZEK M.D.” Practice Location

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