MEDICARE: CATHY ANN PHILLIPS

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
1	103K00000X	Behavior Analyst	2026022903	MO

General Provider Information

NPI Number	:	1467384834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY ANN PHILLIPS

Provider Business Mailing Address
First Line	:	412 WASHINGTON ST
Second Line	:
City	:	FARMER CITY
State	:	IL
Zip	:	61842-1348
Country	:	US
Telephone Number	:	636-232-7106
Fax Number	:

Provider Business Practice Location Address
First Line	:	1972 INNERBELT BUSINESS CENTER DR
Second Line	:
City	:	OVERLAND
State	:	MO
Zip	:	63114-5760
Country	:	US
Telephone Number	:	314-202-4002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ CATHY ANN PHILLIPS ” Practice Location

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