Provider Demographics
NPI:1689145898
Name:S THOMAS SEHY D P M L L C
Entity Type:Organization
Organization Name:S THOMAS SEHY D P M L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PODIATRIST
Authorized Official - Prefix:
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 1:213 NW 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IL
Practice Address - Zip Code:62837-1219
Practice Address - Country:US
Practice Address - Phone:618-842-2522
Practice Address - Fax:618-842-2523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL346767581Medicaid