Provider Demographics
NPI:1790802429
Name:WILLIAMS, ELIZABETH REICHERT (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:REICHERT
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:REICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12855 N. FORTY DR.
Mailing Address - Street 2:STE 375
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-567-6071
Mailing Address - Fax:314-567-3321
Practice Address - Street 1:12855 N. FORTY DR.
Practice Address - Street 2:STE 375
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-567-6071
Practice Address - Fax:314-567-3321
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.124392208800000X
IL0361243922088F0040X
MO20090301132088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
No208800000XAllopathic & Osteopathic PhysiciansUrology