MEDICARE: PRACTICE OF ROSEMARY CANNISTRARO, LLC

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	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DD8725	OTHER	MO	RR MEDICARE

General Provider Information

NPI Number	:	1992848212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRACTICE OF ROSEMARY CANNISTRARO, LLC

Provider Business Mailing Address
First Line	:	232 S WOODS MILL RD
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3417
Country	:	US
Telephone Number	:	314-576-2490
Fax Number	:	314-576-2473

Provider Business Practice Location Address
First Line	:	12609 OLIVE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-6313
Country	:	US
Telephone Number	:	314-205-8344
Fax Number	:	314-205-0217

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RICK SONNE
Credential	:
Telephone Number	:	314-576-2490

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	11/27/2007

Similar Medicare Providers

1619965324 — ADVANCED SURGERY CENTER LLC
Practice Location Address:

12607 OLIVE BLVD
SAINT LOUIS, MO
63141-6313

Practice Phone: 314-205-1610
Practice Fax: 314-205-1233

1376512137 — DR. MARK D. WADE O.D.
Practice Location Address:

12601 OLIVE BLVD
SAINT LOUIS, MO
63141-6313

Practice Phone: 314-336-4690
Practice Fax: 800-432-6004

1700814225 — DR. GREGORY A HILL M.D.
Practice Location Address:

12601 OLIVE BLVD
SAINT LOUIS, MO
63141-6313

Practice Phone: 314-567-7771
Practice Fax: 314-567-7774

1689755209 — ALLAN E. KOLKER, M.D. LLC.
Practice Location Address:

12601 OLIVE BLVD
SAINT LOUIS, MO
63141-6313

Practice Phone: 314-878-7962
Practice Fax: 314-878-7747

1659682235 — CLARKSON OPTOMETRY INC
Practice Location Address:

6313 RONALD REAGAN BLVD
LAKE SAINT LOUIS, MO
63367-2659

Practice Phone: 636-200-4393
Practice Fax: 636-561-2362

1396135992 — NUCROWN, LLC
Practice Location Address:

12607 OLIVE BLVD
SAINT LOUIS, MO
63141-6313

Practice Phone: 314-428-0110
Practice Fax: 314-878-7747

Directions to “PRACTICE OF ROSEMARY CANNISTRARO, LLC ” 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.