Provider Demographics
NPI:1386627404
Name:REBBE, NEIL F (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:F
Last Name:REBBE
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Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:12255 DEPAUL DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044
Mailing Address - Country:US
Mailing Address - Phone:314-344-6021
Mailing Address - Fax:314-344-6131
Practice Address - Street 1:9553 LACKLAND RD
Practice Address - Street 2:STE 1
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-3640
Practice Address - Country:US
Practice Address - Phone:314-429-7733
Practice Address - Fax:314-429-3194
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2020-11-12
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Provider Licenses
StateLicense IDTaxonomies
MO110460208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205278419Medicaid
MO270012989OtherTAX ID ARS PEDIATRICS LLC
MO416385OtherHEALTHLINK