Provider Demographics
NPI:1760044101
Name:ABD EL NOUR, MONICA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ABD EL NOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS PL MSC 8116-0043-08
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-454-6050
Mailing Address - Fax:314-454-2836
Practice Address - Street 1:1 CHILDRENS PL MSC 8116-0043-08
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-454-6050
Practice Address - Fax:314-454-2836
Is Sole Proprietor?:No
Enumeration Date:2019-07-06
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022024166208000000X
IL125075165208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics