MEDICARE: KENDALL A ITOKU MD

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	208800000X	Urology Physician	036091737	IL
2	208800000X	Urology Physician	100178	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	113620031	OTHER	MO	MEDICARE

General Provider Information

NPI Number	:	1699870162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDALL A ITOKU MD

Provider Business Mailing Address
First Line	:	6350 CLAYTON RD APT 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-2514
Country	:	US
Telephone Number	:	314-324-8658
Fax Number	:

Provider Business Practice Location Address
First Line	:	6350 CLAYTON RD APT 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-2514
Country	:	US
Telephone Number	:	314-324-8658
Fax Number	:

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/12/2023

Similar Medicare Providers

1356714893 — MICHELLE LYNN JOCHIM BLACK PH.D.
Practice Location Address:

3800 PARK AVE
SAINT LOUIS, MO
63110-2514

Practice Phone: 314-577-5667
Practice Fax: 314-268-2784

1285145367 — EMILY PRICE LCSW
Practice Location Address:

3800 PARK AVE FL 2
SAINT LOUIS, MO
63110-2514

Practice Phone: 314-268-2700
Practice Fax: 314-268-4028

1578126801 — KATHRYN ALLISON TAYLOR-REICHERT MED, LPC, NCC
Practice Location Address:

2521 CECELIA AVE
SAINT LOUIS, MO
63144-2514

Practice Phone: 314-560-1573
Practice Fax:

1457910747 — BRITTNEY DANIELLE BYRTH MOT, OTR/L
Practice Location Address:

3800 PARK AVE FL 2
SAINT LOUIS, MO
63110-2514

Practice Phone: 314-577-5609
Practice Fax:

1740829266 — ALLISON REICHERT MED LPC LLC
Practice Location Address:

2521 CECELIA AVE.
SAINT LOUIS, MO
63144-2514

Practice Phone: 314-563-1330
Practice Fax:

1558992826 — MS. MARY CLARE MONAHAN LCSW
Practice Location Address:

3800 PARK AVE
SAINT LOUIS, MO
63110-2514

Practice Phone: 314-268-2700
Practice Fax: 314-268-2748

Directions to “ KENDALL A ITOKU MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.