Provider Demographics
NPI:1205864949
Name:ST. LOUIS NEUROLOGICAL INSTITUTE INC.
Entity Type:Organization
Organization Name:ST. LOUIS NEUROLOGICAL INSTITUTE INC.
Other - Org Name:ST. LOUIS NEUROLOGICAL INSTITUTE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-355-3355
Mailing Address - Street 1:11155 DUNN RD
Mailing Address - Street 2:SUITE 202N
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6150
Mailing Address - Country:US
Mailing Address - Phone:314-355-3355
Mailing Address - Fax:314-355-6584
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:SUITE 202N
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-355-3355
Practice Address - Fax:314-355-6584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211503Medicare PIN
MO000010718Medicare PIN