Provider Demographics
NPI:1437698842
Name:S THOMAS SEHY DPM LLC
Entity Type:Organization
Organization Name:S THOMAS SEHY DPM LLC
Other - Org Name:PAGE FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SEHY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:314-423-8811
Mailing Address - Street 1:10430 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1228
Mailing Address - Country:US
Mailing Address - Phone:314-423-8811
Mailing Address - Fax:314-423-8824
Practice Address - Street 1:209 CROSSROADS PL
Practice Address - Street 2:SUITE 130
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6545
Practice Address - Country:US
Practice Address - Phone:314-241-9411
Practice Address - Fax:618-241-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005192213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO305705824Medicaid
IL346767581Medicaid
IL346767581Medicaid
MO305705824Medicaid
IL210109Medicare PIN